Effects of adenoidectomy/adenotonsillectomy on ADHD symptoms and behavioral problems in children.
OBJECTIVE
In children, the most common reason of upper airway obstruction (UAO) is adenotonsillar hypertrophy. In literature, the adverse effects of UAO and obstructive sleep apnea syndrome on behavior and attention in children have been reported in several articles. However, the methods used for the evaluation of behavioral disorders have not been standardized in those studies. The aim of this study was to investigate the behavioral and attention characteristics of children before and after adenoidectomy/adenotonsillectomy using an internationally valid method.


METHODS
A total of 41 patients, between 6 and 11 years of age and having a medical history of UAO for at least one year for which adenotonsillectomy procedure was indicated, were enrolled in the study. The patients were evaluated for signs of attention/behavioral disorders by a child-adolescent psychiatrist and Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children: Present and Lifetime Version (K-SADS-PL) and The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), before and at the 6th month following the operation.


RESULTS
In the preoperative period, a psychiatric disorder was identified by K-SADS-PL in 41.4% (n =1 7) of patients. Of these, 11 patients had attention deficit hyperactivity disorder (ADHD), 6 had enuresis nocturna, and 2 had separation anxiety disorder. Pre- and postoperative mean scores in T-DSM-IV-S parent scale were 31.3 ± 8.5 and 20.2 ± 10.3, respectively, and this difference was statistically significant (p < 0.001).


CONCLUSIONS
The relationship of UAO and attention/behavioral disorders should be taken into consideration by child-adolescent psychiatrists together with ENT specialists and a multidisciplinary approach is important for the treatment team.
Department of Child and Adolescent Psychiatry, Adnan Menderes University, Aydın, Turkey. Electronic address: aksubhatice@yahoo.com.
Hatice
H
Aksu
Department of ENT, Adnan Menderes University, Aydın, Turkey.
Ceren
C
Günel
Department of Child and Adolescent Psychiatry, Adnan Menderes University, Aydın, Turkey.
Börte Gürbüz
BG
Özgür
Department of ENT, Adnan Menderes University, Aydın, Turkey.
Ali
A
Toka
Department of ENT, Adnan Menderes University, Aydın, Turkey.
Sema
S
Başak
D000233:Adenoidectomy; D001010:Anxiety, Separation / Q000150:complications; D001288:Attention; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D053206:Nocturnal Enuresis / Q000150:complications; D011184:Postoperative Period; D057234:Preoperative Period; D000066553:Problem Behavior; D011569:Psychiatric Status Rating Scales; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000523:psychology* / Q000601:surgery*; D014068:Tonsillectomy
Adenoidectomy; Attention deficit; Disruptive behavior disorder; Obstructive sleep apnea; Tonsillectomy