Otorhinolaryngology Department, CHA University, Seongnam, Korea.
Otorhinolaryngology Department, CHA Bundang Medical Center, CHA University, 351 Yatap-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-712, Korea.
World J Pediatr. 2018 Feb;14(1):57-65. doi: 10.1007/s12519-017-0108-4. Epub 2018 Feb 20.
Adenotonsillectomy (AT) has been an effective treatment for sleep-disordered breathing (SDB) in children, and several studies described the risk of postoperative weight gain and obesity in children treated with AT. The present study aimed to evaluate behavioral improvements in children with SDB one year after adenotonsillectomy and to investigate an influence of postoperative weight gain on behaviors.
The study included 170 children aged 5-11 years who underwent adenotonsillectomy for SDB and 150 controls. Body mass index percentile was obtained for age and gender, and parental sleep-related breathing disorder (SRBD) questionnaire was used to assess the severity of SDB. Psychological assessment was performed pre- and post-adenotonsillectomy using standardized questionnaires including strength and difficulties questionnaire, children's depression inventory and screen for child anxiety-related emotional disorder.
The mean age of 170 patients was 7.7 ± 1.5 years with 73 (42.9%) girls and 97 (57.1%) boys. The mean follow-up period were 15.4 ± 2.7 months. The patients had shown significant improvements in SDB scores as well as in questionnaire-based behavioral problems after adenotonsillectomy. The odds of a child being overweight were significantly increased after adenotonsillectomy. Less improvements in hyperactivity and conduct problems were observed in the patients with older ages, higher SRBD scores, and overweight/obesity at 1-year follow-up after adenotonsillectomy.
These data suggest that abnormal behavioral outcomes should be evaluated postoperatively, which potentially could be reduced with the early adenotonsillectomy and adequate postoperative weight control.
腺样体扁桃体切除术（adenotonsillectomy，AT）已被证明是治疗儿童睡眠呼吸障碍（sleep-disordered breathing，SDB）的有效方法，多项研究描述了接受 AT 治疗的儿童术后体重增加和肥胖的风险。本研究旨在评估 SDB 儿童腺样体扁桃体切除术后一年的行为改善情况，并探讨术后体重增加对行为的影响。
该研究纳入了 170 名 5-11 岁因 SDB 接受腺样体扁桃体切除术的儿童和 150 名对照。根据年龄和性别获得体重指数百分位数，使用父母睡眠呼吸障碍问卷评估 SDB 的严重程度。术前和术后使用标准化问卷进行心理评估，包括 strengths and difficulties questionnaire、儿童抑郁量表和儿童焦虑相关情绪障碍筛查。
170 例患者的平均年龄为 7.7±1.5 岁，其中女孩 73 例（42.9%），男孩 97 例（57.1%）。平均随访时间为 15.4±2.7 个月。患者在 SDB 评分以及基于问卷的行为问题方面在腺样体扁桃体切除术后均有显著改善。腺样体扁桃体切除术后，儿童超重的几率显著增加。在腺样体扁桃体切除术后 1 年随访时，年龄较大、SRBD 评分较高和超重/肥胖的患者，多动和品行问题的改善较少。
这些数据表明，术后应评估异常行为结果，早期腺样体扁桃体切除术和术后体重控制可能会降低这种风险。
