Avior Galit, Fishman Gadi, Leor Agnes, Sivan Yakov, Kaysar Nehemia, Derowe Ari
Department of Otolarygology-Head and Neck Surgery, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Israel.
Otolaryngol Head Neck Surg. 2004 Oct;131(4):367-71. doi: 10.1016/j.otohns.2004.04.015.
To evaluate children with obstructive sleep apnea syndrome (OSAS) for features of attention deficit disorder (ADD) using an objective test of inattention and impulsivity: Test of Variables of Attention (TOVA) and then to determine whether tonsillectomy and adenoidectomy (T+A) results in an improvement in TOVA scores.
This study was a prospective interventional comparative trial in a tertiary care children's hospital. Nineteen children ages 5 to 14 years with OSAS, and otherwise healthy, with a clinical indication for T+A. Preoperative and 2 months postoperative OSA-18, CBCL questionnaires, and TOVA scores were evaluated.
The preoperative TOVA scores were in the abnormal range in 12/19 (63%) of the children. The mean preoperative TOVA score was -2.9 (+/- 3.1). The mean postoperative TOVA score was -0.4 (+/-2.8). The improvement in the TOVA scores was significant ( P < 0.0001, t -test).
This preliminary data suggests that treatment of OSAS with T+A results in significant improvement in objective parameters of inattention and impulsivity. Significance These findings may be important in understanding the impact of OSAS and therapeutic interventions on behavioral problems in children.
使用一项针对注意力不集中和冲动的客观测试——注意力变量测试（TOVA），评估患有阻塞性睡眠呼吸暂停综合征（OSAS）的儿童是否具有注意力缺陷障碍（ADD）的特征，然后确定扁桃体切除术和腺样体切除术（T+A）是否能使TOVA评分得到改善。
本研究是在一家三级护理儿童医院进行的前瞻性干预性对照试验。19名年龄在5至14岁、患有OSAS且其他方面健康、有T+A临床指征的儿童。对术前及术后2个月的OSA-18、CBCL问卷和TOVA评分进行了评估。
19名儿童中有12名（63%）术前TOVA评分处于异常范围。术前TOVA评分的平均值为-2.9（±3.1）。术后TOVA评分的平均值为-0.4（±2.8）。TOVA评分的改善具有显著性（P<0.0001，t检验）。
这些初步数据表明，T+A治疗OSAS可使注意力不集中和冲动的客观参数得到显著改善。意义这些发现对于理解OSAS及治疗干预对儿童行为问题的影响可能具有重要意义。
