Impact of adenotonsillectomy on quality of life in children with obstructive sleep disorders.
OBJECTIVE
To determine the impact of adenotonsillectomy on quality of life (QOL) in children with obstructive sleep disorders (OSDs) before and after surgery.


METHODS
Prospective, observational, before-and-after trial.


METHODS
Seven tertiary pediatric otolaryngology practices.


METHODS
Convenience sample of 101 children (mean age, 6.2 years) with adenotonsillar hypertrophy and OSD scheduled for adenotonsillectomy.


METHODS
Adenotonsillectomy was performed in children for OSDs. Quality of life was assessed using the Obstructive Sleep Disorders-6 survey, a validated instrument for detecting QOL change in children with OSDs. Surveys were completed at the initial office visit (visit 1), the day of surgery (visit 2), and at the postoperative office visit (visit 3). Physical characteristics were assessed using tonsillar and orocraniofacial scales (visit 1). Satisfaction with health care decisions was assessed using the Satisfaction With Decision and Satisfaction With Office Visit scales (visit 1).


METHODS
Short-term changes in QOL before (visits 1 and 2) and after (visits 2 and 3) surgery.


RESULTS
Changes in QOL before surgery were trivial or small, and smaller than changes after surgery (mean change score, 0.18 vs 2.3; P<.001). Large, moderate, and small improvements in QOL were seen in 74.5%, 6.1%, and 7.1% of children, respectively. Sleep disturbance, caregiver concern, and physical suffering were the most improved domains, although significant changes also occurred for speech and swallowing problems, emotional disturbance, and activity limitations. Five percent of children had poorer QOL after surgery, but no predictive factors were identified.


CONCLUSIONS
Adenotonsillectomy produces large improvements in at least short-term QOL in most children with OSDs.
De Serres
Lianne M
LM
Division of Pediatric Otolaryngology, The Children's Hospital of New York, 3959 Broadway, Room 501N, New York, NY 10032, USA. LMD54@columbia.edu
Derkay
Craig
C
Sie
Kathleen
K
Biavati
Michael
M
Jones
Jacqueline
J
Tunkel
David
D
Manning
Scott
S
Inglis
Andrew F
AF
Haddad
Joseph
J
Tampakopoulou
Dimitra
D
Weinberg
Alan D
AD
D000233:Adenoidectomy; D002648:Child; D003258:Consumer Behavior; D005260:Female; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D015999:Multivariate Analysis; D010290:Parents; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D014068:Tonsillectomy