title: [Clinical efficacy and polysomnography of adenotonsillectomy in the treatment of sleep-related respiratory disorders in children].
abstract: BACKGROUND
  If sleep-related breathing disorders in children are not treated quickly, they may be harmful to the child's future development. The best diagnostic test is polysomnography, since clinical assessments alone are not enough. Adenotonsillectomy is the most effective and widespread treatment for such disorders.
  
  
  OBJECTIVE
  To assess clinical data on sleep-related breathing disorders, particularly in relation to behaviour and neurocognition, their long-term resolution with surgery and correlation with PSG data.
  
  
  METHODS
  Prospective study with 73 children between 3 and 11 years of age, attending a special clinic for sleep-related breathing disorders. A medical history questionnaire was given to the parents, which included questions on the child's sleep patterns, respiratory disorders and behavioural and neurocognitive changes, and a polysomnography was carried out. Cases requiring surgery were monitored after 9 months by means of a further questionnaire and a follow-up polysomnography.
  
  
  RESULTS
  Of the 73 children tested, 100 % snore, 87.5 % display objective apnoeas and 89 % suffer from nasal congestion. Drowsiness during the day was reported in only 28 %. Over 50 % of cases report aggressiveness or hyperactivity, while 41 % have concentration difficulties. In 61 of the 73 cases (83.6 %) given a pre-operative polysomnography, the mean apnoea-hypopnoea index was 6.44 (4.44). Postoperative follow-up is available for 44 cases, 29 of them with polysomnography. The resolution of clinical symptoms is highly satisfactory in these cases, but 5 patients (17.2 %) still have an apnoea-hypopnoea index of more than 3.
  
  
  CONCLUSIONS
  Adenotonsillectomy is effective in curing the majority of sleep-related respiratory disorder symptoms in children. However, a significant percentage of cases display a persistent polysomnographic change. Long-term postoperative monitoring is recommended in such cases.
authors.affiliation: Servicio de Otorrinolaringología, Hospital General de Catalunya, San Cugat del Vallès, Barcelona, España. esteller@abaforum.es
authors.forename: Eduard
authors.initials: E
authors.lastname: Esteller Moré
authors.forename: Francesc
authors.initials: F
authors.lastname: Segarra Isern
authors.forename: Paula
authors.initials: P
authors.lastname: Huerta Zumel
authors.forename: Ana
authors.initials: A
authors.lastname: Enrique Gonzalez
authors.forename: Eusebi
authors.initials: E
authors.lastname: Matiñó Soler
authors.forename: Joan Manel
authors.initials: JM
authors.lastname: Ademà Alcover
mesh_terms: D000233:Adenoidectomy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D011446:Prospective Studies; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000601:surgery*; D014068:Tonsillectomy; D016896:Treatment Outcome