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Effect of adenotonsillectomy on visual attention tests among children with sleep-disordered breathing: a controlled
C B Abreu1, S C Fuchs, G R Pascoto
1Complexo Hospitalar Edmundo Vasconcelos, São Paulo, Brazil.
Insights
Adenotonsillectomy significantly reduces daytime sleepiness and improves visual attention in children with sleep-disordered breathing. This surgical intervention enhances cognitive functions and overall quality of life for affected pediatric patients.
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Neuroscience
Background:
- Sleep-disordered breathing (SDB) in children is associated with significant daytime sleepiness and attentional deficits.
- Adenotonsillectomy is a common surgical intervention for SDB in pediatric populations.
Purpose of the Study:
- To evaluate the impact of adenotonsillectomy on visual attention and daytime sleepiness in children diagnosed with SDB.
- To compare the outcomes of children undergoing adenotonsillectomy with a control group without SDB.
Main Methods:
- A controlled prospective cohort study involving 27 children (aged 6-17 years) undergoing adenotonsillectomy and 30 age-matched controls.
- Visual attention was assessed using the TAVIS-3 test pre-operatively and 2 months post-operatively.
- Parental interviews gathered data on lifestyle, sleep characteristics, and daytime sleepiness.
Main Results:
- The adenotonsillectomy group showed a significant decrease in daytime sleepiness post-surgery (P < 0.001).
- Children who underwent adenotonsillectomy demonstrated improvements in reaction time and reductions in errors of omission and commission on visual attention tests compared to controls.
- These improvements were observed at both pre-operative and post-operative time points.
Conclusions:
- Adenotonsillectomy is an effective treatment for reducing daytime sleepiness in children with SDB.
- The surgical procedure leads to enhanced performance in visual attention tests, indicating improved cognitive function.
Objective:
This study aimed to evaluate the effect of adenotonsillectomy on visual attention and daytime sleepiness in children with sleep-disordered breathing.
Design:
This was a controlled prospective cohort study.
Setting:
Outpatients from the Otorhinolaryngology Division of Edmundo Vasconcelos Hospital Complex, São Paulo, Brazil.
Participants:
Patients aged 6-17 years with upper airway obstruction scheduled to undergo adenotonsillectomy (treatment group) in the Otorhinolaryngology Division of Edmundo Vasconcelos Hospital Complex, in São Paulo, Brazil. Participants of control group were consecutively selected from another outpatient clinic of paediatric surgery, but those with symptoms of sleep-disordered breathing were excluded.
Main Outcome Measures:
Children were submitted to visual attention tests (TAVIS-3) that discriminates normal subjects from those with attentional disorders in advance of the surgery and 2 months later, and in the same period for the control group. Parents were interviewed about lifestyle, sleep characteristics and daytime sleepiness.
Results:
The analysis included 27 patients in the adenotonsillectomy group and 30 controls, who had similar age (10.0 ± 3.3 versus 10.3 ± 3.7 years; P = 0.8), gender (41% boys versus 57%, respectively) and body mass index. There was marked decrease in daytime sleepiness after surgery (delta between groups: -4.7 ± 3.8; P < 0.001), as well as reductions in reaction time, errors of omission and errors of commission in the treatment compared with the control group at both time points, before and after surgery.
Conclusions:
This study shows that adenotonsillectomy in children and adolescents with sleep-disordered breathing reduces daytime sleepiness and improves the performance in tests of visual attention.
