University of South Australia, Adelaide, Australia.
University of Adelaide, Adelaide, Australia; Department of Respiratory and Sleep Medicine, Women's and Children's Hospital, North Adelaide, Australia.
Sleep Med. 2021 May;81:418-429. doi: 10.1016/j.sleep.2021.02.057. Epub 2021 Mar 11.
Long term follow-up studies (>12 mths) of changes in behavior and quality-of-life (QoL) in children with sleep disordered breathing (SDB) post-adenotonsillectomy are limited and there is a lack of consensus in the reported findings. The aim of this study was to evaluate children's sleep, QoL and behavior at baseline and 6 mths and 48 mths post-adenotonsillectomy for clinically diagnosed SDB.
This prospective longitudinal study of children aged 3-12 y recruited from a Children's Hospital otolaryngology clinic compared polysomnographic parameters, behavior (Child Behavior Checklist; CBCL) and QoL (OSA-18) at baseline, 6mths and 48mths post-adenotonsillectomy and compared these parameters to healthy non-snoring controls recruited from the general community at the same time points.
Sixty-four children completed sleep, behavior and QoL assessments (SDB = 20M/9F, Controls = 18M/17F) at all three time points. Sleep and ventilatory parameters significantly improved in children with SDB with minimal residual obstruction evident at 48 mths post-adenotonsillectomy. Compared to baseline, OSA-18 scores significantly improved post-adenotonsillectomy in children with SDB and were equivalent to the scores of controls at 6 mths and 48 mths post-AT. No significant improvement was observed in behavior in children with SDB post-adenotonsillectomy over the same time period.
Baseline deficits in sleep and QoL in children with SDB were normalized at 6 mths post-adenotonsillectomy and gains were maintained at 48 mths post-adenotonsillectomy. Children with SDB did not show significant gains in behavior either at 6 mths or 48 mths post-adenotonsillectomy.
关于腺样体扁桃体切除术（adenotonsillectomy）后睡眠呼吸障碍（SDB）患儿行为和生活质量（QoL）变化的长期随访研究（>12 个月）有限，且报告结果存在差异。本研究旨在评估经临床诊断为 SDB 的儿童在腺样体扁桃体切除术前后的睡眠、QoL 和行为，分别于基线、6 个月和 48 个月时进行评估。
本前瞻性纵向研究纳入了一家儿童医院耳鼻喉科诊所的 3-12 岁儿童，比较了基线、6 个月和 48 个月时多导睡眠图参数、行为（儿童行为检查表；CBCL）和 QoL（OSA-18），并将这些参数与同时点从普通社区招募的健康非打鼾对照组进行了比较。
64 名儿童完成了所有三个时间点的睡眠、行为和 QoL 评估（SDB=20M/9F，对照组=18M/17F）。SDB 患儿的睡眠和通气参数明显改善，腺样体扁桃体切除术 48 个月后仍有最小残留阻塞。与基线相比，SDB 患儿腺样体扁桃体切除术后 OSA-18 评分显著改善，且在 6 个月和 48 个月时与对照组相当。腺样体扁桃体切除术 6 个月后，SDB 患儿的行为无明显改善。
SDB 患儿基线时的睡眠和 QoL 缺陷在腺样体扁桃体切除术 6 个月后恢复正常，且在腺样体扁桃体切除术 48 个月后仍保持稳定。腺样体扁桃体切除术 6 个月和 48 个月后，SDB 患儿的行为均未显著改善。
