Zaffanello Marco, Pietrobelli Angelo, Zoccante Leonardo, Sacchetto Luca, Nosetti Luana, Piazza Michele, Piacentini Giorgio
Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37129 Verona, Italy.
Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital Verona, 37126 Verona, Italy.
Children (Basel). 2024 Mar 24;11(4):388. doi: 10.3390/children11040388.
(1) Background: Sleep-disordered breathing represents a growing public health concern, especially among children and adolescents. The main risk factors for pediatric sleep-disordered breathing in school-age children are tonsillar and adenoid hypertrophy. Adenoidectomy, often in combination with tonsillectomy, is the primary treatment modality for pediatric sleep-disordered breathing. This study aims to comprehensively investigate various risk and protective factors in children with sleep-disordered breathing undergoing adenotonsillar or adenoidal surgeries. We also aim to explore the differences in neuropsychological profiles. (2) Methods: This is an observational, retrospective cohort study. We collected information on adenoidectomy or adenotonsillectomy in children referred to our center. We reviewed the clinical history and preoperative visits and collected data through a telephone questionnaire. The Pediatric Sleep Questionnaire (PSQ) and the Pediatric Quality of Life Inventory (PedsQL) screen sleep-disordered breathing and quality of life, respectively. The data were statistically analyzed using SPSS version 22.0 for Windows (SPSS Inc., Chicago, IL, USA). (3) Results: The study involved 138 patients, but only 100 children participated. A higher percentage of patients with sleep-disordered breathing were observed to have mothers who smoked during pregnancy. A smaller proportion of patients with sleep-disordered breathing habitually used a pacifier. A rise in physical score was associated with a reduced PSQ at follow-up ( = 0.051). An increase in the overall academic score was related to a decrease in the PSQ at follow-up ( < 0.001). A more significant proportion of patients undergoing adenotonsillectomy were observed to have a history of prematurity and cesarean birth. (4) This comprehensive study delves into the intricate interplay of risk and protective factors impacting children with sleep-disordered breathing undergoing adenotonsillectomy and adenoidectomy.
（1）背景：睡眠呼吸障碍是一个日益受到关注的公共卫生问题，尤其是在儿童和青少年中。学龄儿童小儿睡眠呼吸障碍的主要危险因素是扁桃体和腺样体肥大。腺样体切除术通常与扁桃体切除术联合进行，是小儿睡眠呼吸障碍的主要治疗方式。本研究旨在全面调查接受腺样体或腺样体扁桃体手术的睡眠呼吸障碍儿童的各种风险和保护因素。我们还旨在探讨神经心理特征的差异。（2）方法：这是一项观察性回顾性队列研究。我们收集了转诊至本中心的儿童腺样体切除术或腺样体扁桃体切除术的信息。我们回顾了临床病史和术前就诊情况，并通过电话问卷收集数据。儿童睡眠问卷（PSQ）和儿童生活质量量表（PedsQL）分别用于筛查睡眠呼吸障碍和生活质量。使用适用于Windows的SPSS 22.0版软件（美国伊利诺伊州芝加哥市SPSS公司）对数据进行统计分析。（3）结果：该研究涉及138名患者，但只有100名儿童参与。观察到睡眠呼吸障碍患者中，母亲在孕期吸烟的比例更高。睡眠呼吸障碍患者中习惯性使用安抚奶嘴的比例较小。随访时身体评分升高与PSQ降低相关（=0.051）。随访时总体学业评分升高与PSQ降低相关（<0.001）。观察到接受腺样体扁桃体切除术的患者中，早产和剖宫产史的比例更高。（4）这项综合性研究深入探讨了影响接受腺样体扁桃体切除术和腺样体切除术的睡眠呼吸障碍儿童的风险和保护因素之间的复杂相互作用。
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