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Phonological development in children with obstructive sleep-disordered breathing.

Inger Lundeborg1, Anita McAllister, Christina Samuelsson

  • 1Division of Speech and Language Pathology, Linköping University, Sweden.

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Obstructive sleep disordered breathing (OSDB) significantly impacts children's phonology. Both total tonsillectomy and tonsillotomy improve speech, but the gap with healthy peers persists.

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Area of Science:

  • Pediatric Otolaryngology
  • Speech-Language Pathology
  • Sleep Medicine

Background:

  • Adeno-tonsillar hypertrophy causing obstructive sleep disordered breathing (OSDB) is prevalent in children.
  • OSDB negatively affects oral-motor function, behavior, and academic performance.
  • Adeno-tonsillectomy (total or partial) is a common surgical intervention for OSDB.

Purpose of the Study:

  • To compare the effects of total tonsillectomy (TE) versus tonsillotomy (TT) on phonological outcomes in children with OSDB.
  • To assess the impact of OSDB on phonological function.
  • To evaluate changes in oral motor function post-surgery.

Main Methods:

  • A randomized controlled trial involving 67 children (50-65 months) with OSDB, assigned to TE or TT.
  • Phonological assessment pre-operatively and 6 months post-operatively.
  • Comparison with two control groups of children without OSDB.

Main Results:

  • Pre-operatively, 62.7% of OSDB children had phonological deficits compared to 34% in controls (p < .001).
  • Phonological function improved significantly 6 months after both TE and TT, with no difference between surgical methods.
  • Despite improvement, the phonological gap between OSDB children and controls widened post-surgery.
  • Oral motor function normalized irrespective of surgical approach.

Conclusions:

  • OSDB is a significant contributing factor to phonological impairment in children.
  • While both TE and TT improve phonology, they do not fully close the gap with unaffected peers.
  • Oral motor function recovery is independent of the surgical method used for OSDB treatment.