Di Mauro Paola, Cocuzza Salvatore, Maniaci Antonino, Ferlito Salvatore, Rasà Deborak, Anzivino Roberta, Vicini Claudio, Iannella Giannicola, La Mantia Ignazio
Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", ENT Section, A.O.U. "Policlinico-Vittorio Emanuele", University of Catania, 95124 Catania, Italy.
Otolaryngology Unit, Di Venere Hospital, 70131 Bari, Italy.
Children (Basel). 2021 Oct 15;8(10):921. doi: 10.3390/children8100921.
(1) Background: This systematic review was designed to analyze adenotonsillectomy's role in treating behavioural disorders and sleep-related quality of life in pediatric OSAS. (2) Methods: Papers that report pre-operative and post-operative outcomes by using the Epworth sleepiness scale, OSA-18, NEPSY, Conners' rating scale, BRIEF, PSQ-SRBD, PedsQL and CBCL. We performed a comprehensive review of English papers published during the last 20 years regarding behavioural disorders in OSAS patients and adenotonsillectomy. (3) Results: We included 11 studies reporting behavioral outcomes and sleep related quality of life after surgery. We investigated changes in behavior and cognitive outcomes after AT, and we found significant improvements of the scores post-AT in almost all studies. After comparing the AT group and control group, only one study had no difference that reached significance at one year post-AT. In another study, it did not show any significant improvement in terms of all behavioural and cognitive outcomes. The questionnaires on sleep-related quality of life after AT (PSQ-SRBD or ESS or OSA-18 or KOSA) may improve with positive changes in sleep parameters (AHI, ODI and SpO2). Furthermore, there is a significantly higher decrease in OSAS symptoms than the pre-AT baseline score. (4) Conclusion: Future studies should pay more attention to characterizing patient populations as well as rapid surgical treatments through existing criteria.
(1) 背景：本系统评价旨在分析腺样体扁桃体切除术在治疗小儿阻塞性睡眠呼吸暂停（OSAS）的行为障碍和睡眠相关生活质量方面的作用。(2) 方法：通过使用爱泼华嗜睡量表、OSA-18、NEPSY、康纳斯评定量表、BRIEF、儿童睡眠相关呼吸障碍患者生活质量量表（PSQ-SRBD）、儿童生活质量量表（PedsQL）和儿童行为量表（CBCL）来报告术前和术后结果的论文。我们对过去20年发表的关于OSAS患者行为障碍和腺样体扁桃体切除术的英文论文进行了全面综述。(3) 结果：我们纳入了11项报告术后行为结果和睡眠相关生活质量的研究。我们调查了腺样体扁桃体切除术后行为和认知结果的变化，并且发现在几乎所有研究中术后得分都有显著改善。比较腺样体扁桃体切除术组和对照组后，只有一项研究在腺样体扁桃体切除术后一年没有达到显著差异。在另一项研究中，在所有行为和认知结果方面均未显示出任何显著改善。腺样体扁桃体切除术后睡眠相关生活质量问卷（PSQ-SRBD或ESS或OSA-18或KOSA）可能会随着睡眠参数（呼吸暂停低通气指数、氧减指数和血氧饱和度）的积极变化而改善。此外，OSAS症状的下降明显高于腺样体扁桃体切除术前的基线评分。(4) 结论：未来的研究应更多地关注通过现有标准对患者群体进行特征描述以及快速手术治疗。
