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Asthma control in normal weight and overweight/obese asthmatic children following adenotonsillectomy

Gary D Josephson1, Joshua B Bradshaw2, Cheyenne Roohani2

  • 1Division of Pediatric Otolaryngology, Nemours Children's Health, Jacksonville, FL, USA.

Ear, Nose, & Throat Journal
|December 2, 2022
PubMed

Insights

Adenotonsillectomy improved asthma control in children with sleep-disordered breathing (SDB). Normal-weight children showed significant improvements in asthma control (cACT) and quality of life (PACQLQ) at 3 and 6 months post-surgery. Obese children also experienced benefits, particularly at 6 months.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Pulmonology
  • Sleep Medicine

Background:

  • Childhood adenotonsillar hypertrophy (ATH) often co-occurs with asthma and sleep-disordered breathing (SDB).
  • Adenotonsillectomy has been linked to reduced asthma severity.
  • This study investigates asthma control changes post-adenotonsillectomy in relation to children's weight status.

Purpose of the Study:

  • To evaluate the impact of adenotonsillectomy on asthma control in children with SDB.
  • To compare outcomes between nonobese/normal-weight and obese/overweight children.
  • To assess changes in quality of life for caregivers.

Main Methods:

  • Prospective, nonrandomized cohort trial with 6-month follow-up.
  • 41 children with persistent asthma and SDB undergoing adenotonsillectomy were enrolled.
  • Patients stratified by BMI (≤85th percentile vs. >85th percentile); primary outcome: change in Childhood Asthma Control Test (cACT) scores; secondary outcome: Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ) scores.

Main Results:

  • Nonobese/normal-weight children (n=26) showed significant cACT improvement at 3 and 6 months (P<.001 and P=.044, respectively).
  • Obese/overweight children (n=10) demonstrated significant cACT improvement at 6 months (P=.048).
  • PACQLQ scores improved significantly at 3 and 6 months for both groups (P<.001).

Conclusions:

  • Adenotonsillectomy is an effective treatment option for children with comorbid SDB and asthma.
  • Nonobese/normal-weight children experienced more rapid and significant improvements in asthma control.
  • Caregiver quality of life improved across all participants, highlighting the broader benefits of the surgical intervention.

Keywords:
adenotonsillar hypertrophyadenotonsillectomyasthmachildrensleep-disordered breathing

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