Smith E, Wenzel S, Rettinger G, Fischer Y
Hals-Nasen-Ohren-Klinik Universität Ulm.
Laryngorhinootologie. 2008 Jul;87(7):490-7. doi: 10.1055/s-2007-995627. Epub 2008 Apr 11.
To study the effectiveness of adenotomy (AT), adenotonsillectomy (ATE) and adenotonsillotomy (ATT) with respect to the quality of life improvement in children with obstructive sleep disorders (OSD), OSA 18 survey and Brouillette score were used.
Prospectively, 92 children with an age ranging from 2 to 6 years with OSD underwent AT, ATE or ATT at the University hospital of Ulm (Germany), respectively. 30 age-matched children served as controls. Caregivers were requested to complete the Brouillette score and the OSA 18 survey, which are validated instruments for detecting symptoms and quality of life change in children with OSDs, at the initial office visit prior to surgery (BS/1 and OSA 18/1) and 7 - 14 months after surgery (BS/2 and OSA 18/2).
The mean total score of the OSA 18 survey for AT, ATE and ATT was reduced significantly after these operations (p < 0.001). Similar results were also observed in the Brouillette score (p < 0.002). The improvement of life quality in the AT group was less effective than in the ATE and ATT group.
ATE and ATT have about the same effectiveness to improve life quality for children with OSD. Children after ATE or ATT have a comparable life quality as healthy children (Mann Whitney U-test; p approximately 0.15), while children who only received AT have a slightly lower life quality after the operation. In summary, ATT was recommend.
为研究腺样体切除术（AT）、腺样体扁桃体切除术（ATE）和腺样体扁桃体切开术（ATT）对改善阻塞性睡眠障碍（OSD）儿童生活质量的效果，采用了OSA 18调查问卷和布罗伊lette评分。
前瞻性地，92名年龄在2至6岁的OSD儿童分别在德国乌尔姆大学医院接受了AT、ATE或ATT手术。30名年龄匹配的儿童作为对照。要求护理人员在手术前的初次门诊（BS/1和OSA 18/1）以及手术后7至14个月（BS/2和OSA 18/2）完成布罗伊lette评分和OSA 18调查问卷，这两种工具可有效检测OSD儿童的症状和生活质量变化。
AT、ATE和ATT手术后，OSA 18调查问卷的平均总分显著降低（p < 0.001）。布罗伊lette评分也有类似结果（p < 0.002）。AT组生活质量的改善效果不如ATE组和ATT组。
ATE和ATT对改善OSD儿童生活质量的效果大致相同。接受ATE或ATT手术的儿童生活质量与健康儿童相当（曼-惠特尼U检验；p约为0.15），而仅接受AT手术的儿童术后生活质量略低。总之，推荐ATT手术。
