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Published on: December 6, 2016
Randomised trial showed no difference in behavioural symptoms between surgical methods treating paediatric
Isabella Sjölander1, Anna Borgström2, Jan-Olov Larsson3
1Department of Surgical Sciences, Otorhinolaryngology-Head and Neck Surgery, Uppsala University, Uppsala, Sweden.
Insights
Adenotonsillotomy (ATT) and adenotonsillectomy (ATE) show similar outcomes for behavioral symptoms in children with obstructive sleep apnea (OSA). Both procedures significantly improved overall behavioral symptoms after surgery.
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Child Psychology
Background:
- Obstructive sleep apnea (OSA) is common in children.
- Previous studies showed no difference between adenotonsillectomy (ATE) and adenotonsillotomy (ATT) for respiratory and quality of life outcomes.
- Behavioral symptoms are a key concern in pediatric OSA.
Purpose of the Study:
- To evaluate the impact of ATE versus ATT on behavioral symptoms in children with OSA.
- To compare behavioral symptom changes using the Strengths and Difficulties Questionnaire (SDQ).
Main Methods:
- A randomized controlled trial comparing ATE and ATT in children aged 2-6 years with OSA.
- Parents completed the SDQ preoperatively and 1 year post-surgery.
- Polysomnography was used to confirm OSA diagnosis.
Main Results:
- No significant differences in total SDQ scores were found between the ATE and ATT groups at follow-up (P=0.09).
- The overall cohort demonstrated a significant improvement in SDQ scores post-surgery (P=0.0002).
- SDQ data was collected from 87% preoperatively and 86% postoperatively.
Conclusions:
- Adenotonsillotomy (ATT) is a viable, conservative treatment option for pediatric obstructive sleep apnea (OSA).
- Both ATT and ATE lead to significant improvements in behavioral symptoms in children with OSA.
- Further research may explore long-term behavioral outcomes.
Aim:
Our previous randomised controlled trial of children with obstructive sleep apnoea (OSA) showed no significant differences between adenotonsillectomy (ATE) and adenotonsillotomy (ATT) in improving nocturnal respiration and quality of life after 1 year. The aim of this report was to evaluate the effects on behavioural symptoms using the Strengths and Difficulties Questionnaire (SDQ).
Methods:
Children between 2 and 6 years with OSA were randomised to ATT or ATE. Parents, blinded to method, answered the SDQ while their child underwent polysomnography before and 1 year after surgery. Differences between the total SDQ scores were analysed between the treatment groups.
Results:
The SDQ was filled out in 87% of the cases preoperatively, and in 86% postoperatively. At follow-up, the mean total SDQ score was 9.6 SD ± 5.1 in the ATE group (n = 31), and 8.2 ± 6.7 in the ATT group (n = 37), P = .09. The mean total SDQ score for all was preoperatively 10.6 ± 5.0, and postoperatively 8.8 ± 6.0, P = .0002.
Conclusion:
There were no significant differences in SDQ scores between the groups at follow-up, indicating that the more conservative ATT is a treatment option in paediatric OSA. The whole group of patients showed a significant improvement after surgery.
