[Impact of adenotonsillectomy on quality of life in children with sleep disordered breathing].

Objective: To compare improvement in quality of life after adenotonsillectomy in children with similar demographics but with either obstructive sleep apnea hypopnea syndrome (OSAHS) or with milder forms of sleep-disordered breathing (SDB). To evaluate the relationship between polysomnogram (PSG) results and disease-specific quality of life for children with obstructive sleep apnea 18 item survey (OSA-18).

Method: Children with SDB who were suspected of having OSAHS were enrolled. All study participants underwent overnight PSG using standardized techniques. The effectiveness of adenotonsillectomy for the relief of SDB was evaluated by using the OSA-18. Follow-up was assessed at 6-9 months. Preoperative and postoperative OSA-18 scores for each group of children (OSAHS and mild SDB) were compared.

Result: The study population included 51 children with SDB, and 28 of them met PSG criteria for OSAHS, the other 23 of them without OSAHS. The clinical data in the two groups were similar. OSA-18 scores were not significantly different between children with and without OSAHS. The total OSA-18 scores and the scores for all domains showed significant improvement after surgery for both groups of children (P<0.01). A comparison of mean difference in total and domain scores for the two groups of children was not significant (P>0.05). The domains of sleep disturbance, physical suffering and caregiver concerns showed significant association with PSG parameters (P<0.01). But no strong association was identified for OSA-18 total scores and other two domains (P>0.05).

Conclusion: Both groups of children showed a dramatic improvement in quality of life after adenotonsillectomy and the degree of improvement was similar. Fortunately, surgical therapy with adenotonsillectomy was associated with marked improvement in quality of life for children with either OSAHS or mild SDB. However, the association between PSG findings and OSA-18 scores was only moderate.