Fidan Tulin, Fidan Vural
Atatürk University, Faculty of Medicine, Department of Child Psychiatry, Erzurum, Turkey.
Erzurum State Hospital, Otolaryngology Clinic, Erzurum, Turkey.
Eurasian J Med. 2008 Apr;40(1):14-7.
The objective of this study is to investigate the impact of adenotonsillectomy on the neuropsychology of children using the Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-Scale).
Thirty children admitted to an otolaryngology clinic for treatment of sleep-disordered breathing or recurrent tonsillitis and who underwent adenotonsillectomy were included the study. All parents completed the T-DSM-IV-Scale before surgery and after 3 months of surgery. The T-DSM-IV-Scale consists of four sub-scales: inattention, hyperactivity, oppositional-defiant disorders, and conduct disorders. SPSS 15 por Windows was used to evaluate the datas.
Of the 30 children, 17 (56.7%) were boys and13 (43.3 %) were girls. The age range was between four and fourteen years, and the mean age was 6.6±2.6 years. The most common complaints of the children in their first admission to the otorhinolaryngology clinic were snoring (n = 25, or 83.3%), breathing from the mouth (n = 25, or 83.3%), stuffiness (n = 16, or 53.3%), post-nasal drip (n = 15, or 50%), halitosis (n = 14, or 46.7%), and odontoprisis (n = 12, or 40%). We found a statistically significant difference between the mean scores of the inattention, hyperactivity, oppositional-defiant disorders, and conduct disorder sub-scales of T-DSM-IV-Scale before and three months post-tonsillectomy (P<0.05).
In SDB inattention, hyperactivity and other neurobehavioral problems can be seen. This may cause a delay in accurate diagnosis and treatment. Children having neurobehavioral problems such as inattention, hyperactivity, oppositional-defiant disorders, and conduct disorder symptoms can be assessed for sleep-disordered breathing. After adenotonsillectomy, these neurobehavioral problems can improve without psychiatric medication; thus, adenotonsillectomy may have a positive impact on the neurobehavioral problems of children with sleep-disordered breathing.
本研究的目的是使用基于图尔盖《精神疾病诊断与统计手册》第四版的儿童和青少年破坏性行为障碍筛查与评定量表（T-DSM-IV量表），调查腺样体扁桃体切除术对儿童神经心理学的影响。
本研究纳入了30名因睡眠呼吸障碍或复发性扁桃体炎入住耳鼻喉科诊所并接受腺样体扁桃体切除术的儿童。所有家长在手术前和术后3个月完成T-DSM-IV量表。T-DSM-IV量表由四个子量表组成：注意力不集中、多动、对立违抗障碍和品行障碍。使用SPSS 15 for Windows评估数据。
30名儿童中，17名（56.7%）为男孩，13名（43.3%）为女孩。年龄范围在4至14岁之间，平均年龄为6.6±2.6岁。儿童首次入住耳鼻喉科诊所时最常见的症状是打鼾（n = 25，或83.3%）、口呼吸（n = 25，或83.3%）、鼻塞（n = 16，或53.3%）、鼻后滴漏（n = 15，或50%）、口臭（n = 14，或46.7%）和磨牙（n = 12，或40%）。我们发现，T-DSM-IV量表的注意力不集中、多动、对立违抗障碍和品行障碍子量表在扁桃体切除术前和术后3个月的平均得分之间存在统计学显著差异（P<0.05）。
在睡眠呼吸障碍中可出现注意力不集中、多动和其他神经行为问题。这可能导致准确诊断和治疗的延迟。对于有注意力不集中、多动、对立违抗障碍和品行障碍症状等神经行为问题的儿童，可评估其睡眠呼吸障碍情况。腺样体扁桃体切除术后，这些神经行为问题无需精神科药物治疗即可改善；因此，腺样体扁桃体切除术可能对患有睡眠呼吸障碍的儿童的神经行为问题产生积极影响。
