[Clinical efficacy and polysomnography of adenotonsillectomy in the treatment of sleep-related respiratory disorders in children].
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.
Esteller Moré
Eduard
E
Servicio de Otorrinolaringología, Hospital General de Catalunya, San Cugat del Vallès, Barcelona, España. esteller@abaforum.es
Segarra Isern
Francesc
F
Huerta Zumel
Paula
P
Enrique Gonzalez
Ana
A
Matiñó Soler
Eusebi
E
Ademà Alcover
Joan Manel
JM
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