The effect of tonsillectomy and adenoidectomy on inattention and impulsivity as measured by the Test of Variables of Attention (TOVA) in children with obstructive sleep apnea syndrome.
OBJECTIVE
To evaluate children with obstructive sleep apnea syndrome (OSAS) for features of attention deficit disorder (ADD) using an objective test of inattention and impulsivity: Test of Variables of Attention (TOVA) and then to determine whether tonsillectomy and adenoidectomy (T+A) results in an improvement in TOVA scores.


METHODS
This study was a prospective interventional comparative trial in a tertiary care children's hospital. Nineteen children ages 5 to 14 years with OSAS, and otherwise healthy, with a clinical indication for T+A. Preoperative and 2 months postoperative OSA-18, CBCL questionnaires, and TOVA scores were evaluated.


RESULTS
The preoperative TOVA scores were in the abnormal range in 12/19 (63%) of the children. The mean preoperative TOVA score was -2.9 (+/- 3.1). The mean postoperative TOVA score was -0.4 (+/-2.8). The improvement in the TOVA scores was significant ( P < 0.0001, t -test).


CONCLUSIONS
This preliminary data suggests that treatment of OSAS with T+A results in significant improvement in objective parameters of inattention and impulsivity. Significance These findings may be important in understanding the impact of OSAS and therapeutic interventions on behavioral problems in children.
Department of Otolarygology-Head and Neck Surgery, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Israel.
Galit
G
Avior
Gadi
G
Fishman
Agnes
A
Leor
Yakov
Y
Sivan
Nehemia
N
Kaysar
Ari
A
Derowe
D000233:Adenoidectomy; D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000209:etiology / Q000628:therapy*; D008297:Male; D020181:Sleep Apnea, Obstructive / Q000150:complications*; D011795:Surveys and Questionnaires; D014068:Tonsillectomy; D016896:Treatment Outcome