title: Impact of tonsillectomy and adenoidectomy on child behavior.
abstract: OBJECTIVE
  To measure the impact of tonsillectomy and adenoidectomy (T&A) on children's behavioral and emotional problems using a standardized assessment.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Tertiary care children's hospital.
  
  
  METHODS
  Thirty-six children, aged 2 through 18 years, with symptoms of nighttime snoring, observed apneas, and daytime mouth breathing and physical examination results demonstrating 3+ or 4+ tonsils scheduled for T&A.
  
  
  METHODS
  Parents completed a standard survey of their children's symptoms of sleep apnea and a standardized measure of children's competencies and problems, the Child Behavior Checklist for ages 2 through 3 years or 4 through 18 years, before T&A and 3 months postoperatively.
  
  
  METHODS
  The Child Behavior Checklist total problem score.
  
  
  RESULTS
  The preoperative Child Behavior Checklist total problem score was consistent with abnormal behavior for 10 children (28%). After T&A (n = 15), only 2 scores were abnormal, but the change was not statistically significant. In contrast, the mean total problem score was 7.5 points lower after surgery (95% confidence interval, 5.1-9.7), indicating a significant decrease (P<.001, matched t test).
  
  
  CONCLUSIONS
  This pilot study demonstrates a high prevalence (28%) of abnormal behavior in children undergoing T&A for chronic upper airway obstruction. Scores on a standardized measure of behavior improve following T&A, but larger studies with increased statistical power are needed to clarify the degree of improvement and its clinical importance.
authors.affiliation: Division of Pediatric Otolaryngology, State University of New York Health Science Center at Brooklyn 11203-2098, USA. ngoldstein@netmail.hscbklyn.edu
authors.forename: N A
authors.initials: NA
authors.lastname: Goldstein
authors.forename: J C
authors.initials: JC
authors.lastname: Post
authors.forename: R M
authors.initials: RM
authors.lastname: Rosenfeld
authors.forename: T F
authors.initials: TF
authors.lastname: Campbell
mesh_terms: D000233:Adenoidectomy / Q000523:psychology*; D002652:Child Behavior; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011184:Postoperative Period; D015995:Prevalence; D011446:Prospective Studies; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000523:psychology / Q000601:surgery*; D011795:Surveys and Questionnaires; D014068:Tonsillectomy / Q000523:psychology*