Fallah Reza, Arabi Mianroodi Aliasghar, Eslami Mahin, Khanjani Narges
Iran J Otorhinolaryngol. 2020 Nov;32(113):359-364. doi: 10.22038/ijorl.2020.43987.2456.
Attention deficit hyperactivity disorder (ADHD) has the highest prevalence among psychiatric disorders in children. The present study investigated the effect of adenotonsillectomy on the symptoms of ADHD in a 6-month follow-up.
This cross-sectional study was performed on 100 patients referred for respiratory problems during sleep due to adenotonsillar hypertrophy (ATH). The patients' parents were asked to complete the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition checklist as a standard benchmark for ADHD before, 2 weeks, and 6 months after the surgery. The data were analyzed by SPSS software (version 20) through paired t-tests and McNemar's test.
The age averages of male and female children were 7.15 and 8.4 years, respectively. The frequency of ADHD in the studied population was 30%, which is much higher than the prevalence of this disorder in the normal population. In the second week after the surgery, the mean score of ADHD decreased from 4.97±2.97 (attention deficit [AD]) and 6.77±1.61 (hyperactivity disorder [HD]) before the surgery to 3.86±2.25 (AD) and 4.28±2.02 (HD) 2 weeks after the surgery (P=0.001). After a 6-month follow-up, these figures further decreased (AD=2.34±2.32; HD=1.97±2.44; P<0.001).
Adenotonsillectomy had a significant effect on the improvement of ADHD symptoms. There is a necessity for checking patients with ADHD for ATH, especially in case of sleep disorders, sleep apnea, snoring, or mouth breathing.
注意缺陷多动障碍(ADHD)在儿童精神疾病中患病率最高。本研究在6个月的随访中调查了腺样体扁桃体切除术对ADHD症状的影响。
本横断面研究对100例因腺样体扁桃体肥大(ATH)导致睡眠呼吸问题前来就诊的患者进行。要求患者家长在手术前、术后2周和6个月完成《精神疾病诊断与统计手册》第四版检查表,作为ADHD的标准基准。数据通过SPSS软件(版本20)进行配对t检验和McNemar检验分析。
男童和女童的平均年龄分别为7.15岁和8.4岁。研究人群中ADHD的发生率为30%,远高于正常人群中该疾病的患病率。术后第二周,ADHD的平均得分从术前的4.97±2.97(注意力缺陷[AD])和6.77±1.61(多动障碍[HD])降至术后2周的3.86±2.25(AD)和4.28±2.02(HD)(P = 0.001)。6个月随访后,这些数字进一步下降(AD = 2.34±2.32;HD = 1.97±2.44;P < 0.001)。
腺样体扁桃体切除术对改善ADHD症状有显著效果。有必要对ADHD患者进行ATH检查,尤其是在出现睡眠障碍、睡眠呼吸暂停、打鼾或口呼吸的情况下。