Effects of adenoidectomy/adenotonsillectomy on ADHD symptoms and behavioral problems in children
Hatice Aksu1, Ceren Günel2, Börte Gürbüz Özgür1
1Department of Child and Adolescent Psychiatry, Adnan Menderes University, Aydın, Turkey.
Insights
Adenotonsillar hypertrophy causing upper airway obstruction (UAO) in children is linked to behavioral issues. Adenoidectomy/adenotonsillectomy significantly improved attention and behavioral symptoms in a study of pediatric patients.
Area of Science:
- Pediatric Otolaryngology
- Child Psychiatry
- Sleep Medicine
Background:
- Adenotonsillar hypertrophy is a common cause of upper airway obstruction (UAO) in children.
- Previous studies suggest a link between UAO, obstructive sleep apnea syndrome, and behavioral/attention deficits in children.
- Standardized methods for evaluating these behavioral disorders have been lacking.
Purpose of the Study:
- To investigate behavioral and attention characteristics in children before and after adenoidectomy/adenotonsillectomy.
- To utilize an internationally validated method for assessing behavioral and attention disorders.
Main Methods:
- Forty-one children (6-11 years) with a history of UAO requiring adenotonsillectomy were enrolled.
- Psychiatric evaluations were conducted using the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL) and the Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S).
- Assessments were performed preoperatively and at 6 months postoperatively.
Main Results:
- Preoperatively, 41.4% of patients had psychiatric disorders, including attention deficit hyperactivity disorder (ADHD), enuresis nocturna, and separation anxiety disorder.
- Mean scores on the T-DSM-IV-S parent scale significantly decreased from 31.3 ± 8.5 preoperatively to 20.2 ± 10.3 postoperatively (p < 0.001).
Conclusions:
- A significant improvement in behavioral and attention symptoms was observed after adenoidectomy/adenotonsillectomy.
- The study highlights the importance of considering the relationship between UAO and behavioral disorders.
- A multidisciplinary approach involving child psychiatrists and ENT specialists is recommended for optimal treatment.
Objectives:
In children, the most common reason of upper airway obstruction (UAO) is adenotonsillar hypertrophy. In literature, the adverse effects of UAO and obstructive sleep apnea syndrome on behavior and attention in children have been reported in several articles. However, the methods used for the evaluation of behavioral disorders have not been standardized in those studies. The aim of this study was to investigate the behavioral and attention characteristics of children before and after adenoidectomy/adenotonsillectomy using an internationally valid method.
Methods:
A total of 41 patients, between 6 and 11 years of age and having a medical history of UAO for at least one year for which adenotonsillectomy procedure was indicated, were enrolled in the study. The patients were evaluated for signs of attention/behavioral disorders by a child-adolescent psychiatrist and Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children: Present and Lifetime Version (K-SADS-PL) and The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), before and at the 6th month following the operation.
Results:
In the preoperative period, a psychiatric disorder was identified by K-SADS-PL in 41.4% (n =1 7) of patients. Of these, 11 patients had attention deficit hyperactivity disorder (ADHD), 6 had enuresis nocturna, and 2 had separation anxiety disorder. Pre- and postoperative mean scores in T-DSM-IV-S parent scale were 31.3 ± 8.5 and 20.2 ± 10.3, respectively, and this difference was statistically significant (p < 0.001).
Conclusion:
The relationship of UAO and attention/behavioral disorders should be taken into consideration by child-adolescent psychiatrists together with ENT specialists and a multidisciplinary approach is important for the treatment team.
Related Concept Videos
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
01:30Oppositional Defiant Disorder
Diagnostic Criteria and...
01:26Tonsillitis II: Management
01:30Adrenergic Agonists: Therapeutic Uses
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and...
01:19Autism Spectrum Disorder
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.