The impact of adenotonsillectomy on attention-deficit hyperactivity and disruptive behavioral symptoms
1Atatürk University, Faculty of Medicine, Department of Child Psychiatry, Erzurum, Turkey.
Insights
Adenotonsillectomy significantly improved neurobehavioral issues like inattention and hyperactivity in children with sleep-disordered breathing. This suggests adenotonsillectomy can positively impact children's behavior without psychiatric medication.
Area of Science:
- Pediatric Otolaryngology
- Child and Adolescent Psychiatry
- Sleep Medicine
Background:
- Sleep-disordered breathing (SDB) and recurrent tonsillitis are common pediatric conditions.
- Neurobehavioral problems, including inattention and hyperactivity, can be associated with SDB.
- These behavioral issues may complicate diagnosis and treatment of underlying SDB.
Purpose of the Study:
- To evaluate the effect of adenotonsillectomy on the neuropsychological status of children.
- To assess changes in disruptive behavioral disorder symptoms post-surgery.
Main Methods:
- A cohort of 30 children with SDB or recurrent tonsillitis underwent adenotonsillectomy.
- The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-Scale) was administered pre- and 3-months post-surgery.
- Data analysis utilized SPSS software.
Main Results:
- The study included 17 boys and 13 girls, aged 4-14 years (mean 6.6 years).
- Common presenting complaints included snoring and mouth breathing (83.3% each).
- Statistically significant improvements were observed in inattention, hyperactivity, oppositional-defiant, and conduct disorder sub-scale scores post-adenotonsillectomy (P<0.05).
Conclusions:
- Adenotonsillectomy can lead to significant improvements in neurobehavioral problems in children with SDB.
- Assessment for SDB is recommended in children presenting with neurobehavioral issues.
- Adenotonsillectomy offers a potential non-pharmacological treatment for these behavioral symptoms.
Objective:
The objective of this study is to investigate the impact of adenotonsillectomy on the neuropsychology of children using the Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-Scale).
Materials And Methods:
Thirty children admitted to an otolaryngology clinic for treatment of sleep-disordered breathing or recurrent tonsillitis and who underwent adenotonsillectomy were included the study. All parents completed the T-DSM-IV-Scale before surgery and after 3 months of surgery. The T-DSM-IV-Scale consists of four sub-scales: inattention, hyperactivity, oppositional-defiant disorders, and conduct disorders. SPSS 15 por Windows was used to evaluate the datas.
Results:
Of the 30 children, 17 (56.7%) were boys and13 (43.3 %) were girls. The age range was between four and fourteen years, and the mean age was 6.6±2.6 years. The most common complaints of the children in their first admission to the otorhinolaryngology clinic were snoring (n = 25, or 83.3%), breathing from the mouth (n = 25, or 83.3%), stuffiness (n = 16, or 53.3%), post-nasal drip (n = 15, or 50%), halitosis (n = 14, or 46.7%), and odontoprisis (n = 12, or 40%). We found a statistically significant difference between the mean scores of the inattention, hyperactivity, oppositional-defiant disorders, and conduct disorder sub-scales of T-DSM-IV-Scale before and three months post-tonsillectomy (P<0.05).
Conclusion:
In SDB inattention, hyperactivity and other neurobehavioral problems can be seen. This may cause a delay in accurate diagnosis and treatment. Children having neurobehavioral problems such as inattention, hyperactivity, oppositional-defiant disorders, and conduct disorder symptoms can be assessed for sleep-disordered breathing. After adenotonsillectomy, these neurobehavioral problems can improve without psychiatric medication; thus, adenotonsillectomy may have a positive impact on the neurobehavioral problems of children with sleep-disordered breathing.
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