Long-term parental satisfaction with adenotonsillectomy: a population study.
OBJECTIVE
This study reports the presence of sleep-disordered breathing (SDB) symptoms among first graders. We evaluated the severity of symptoms and parental satisfaction in children who had undergone adenotonsillectomy (T&A) compared to children who never had T&A.


METHODS
A population-based, cross-sectional study was conducted. Parent-reported questionnaire data including age, weight, height, BMI, history of T&A, and SDB symptoms (snoring intensity, observed dyspneas, mouth breathing during sleep) were analyzed.


RESULTS
Of 3580 eligible children, 2504 (69.9 %) returned questionnaires. Two hundred fifty-nine (10.3 %) children had a history of T&A. Within this group, 76 % of parents were still satisfied with their child's outcome after surgery. The satisfaction rate decreased from 88.9 % in those who had surgery within 1 year to 71.3 % in those who had surgery ≥3 years prior. The mean values of intensity for all analyzed SDB symptoms on a five-point scale were significantly higher for children who had ever undergone T&A when compared to those who never underwent surgery [e.g., snoring (2.11 vs 1.87; P = 0.0004), dyspneas (1.64 vs 1.22; P < 0.0001), and mouth breathing during sleep (2.95 vs 2.58; P < 0.0001)]. For those who had undergone T&A, 24 % of caregivers were not satisfied with the surgical outcome and the symptom intensity was highest (snoring = 3.16, dyspneas = 2.20, and mouth breathing = 4.23) for these children.


CONCLUSIONS
The mean SDB symptom intensity was significantly higher in children who had undergone T&A when compared to those who had not. The elevated symptom intensity in those children whose caregivers were not satisfied after T&A suggests possible SDB recurrence and need for further evaluation.
Department of Otorhinolaryngology, Medical University of Warsaw, 19/25 Stepinska Street, 00-739, Warsaw, Poland. wkukwa@yahoo.pl.|Medical University of Warsaw, 10/55 Dworkowa Street, 05-077, Warsaw, Poland. wkukwa@yahoo.pl.
Wojciech
W
Kukwa
Department of Otolaryngology and Head and Neck Disease, School of Medicine, University of Varmia and Mazuria, 30 Warszawska Street, 10-082, Olsztyn, Poland.|Healthy Sleep Foundation, 10/55 Dworkowa Street, 05-077, Warsaw, Poland.
Andrzej
A
Kukwa
Healthy Sleep Foundation, 10/55 Dworkowa Street, 05-077, Warsaw, Poland.
Adam
A
Galazka
Laboratory of Molecular Oncology, Department of Oncology, Military Institute of Medicine, 128 Szaserow Street, 04-141, Warsaw, Poland.
Anna M
AM
Czarnecka
Department of Otorhinolaryngology, Medical University of Warsaw, 19/25 Stepinska Street, 00-739, Warsaw, Poland.
Antoni
A
Krzeski
Department of Otorhinolaryngology, Medical University of Warsaw, 19/25 Stepinska Street, 00-739, Warsaw, Poland.
Ewa
E
Migacz
Division of Pediatric Otolaryngology - Head & Neck Surgery and Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|Department of Otolaryngology - Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Stacey L
SL
Ishman
D000233:Adenoidectomy; D002648:Child; D003258:Consumer Behavior; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D011183:Postoperative Complications / Q000175:diagnosis / Q000523:psychology; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000523:psychology / Q000601:surgery*; D011795:Surveys and Questionnaires; D014068:Tonsillectomy; D016896:Treatment Outcome
Adenotonsillectomy; Children; Questionnaire; Sleep-disordered breathing; Snoring