Immediate and Sustained Improvement in Behavior and Life Quality by Adenotonsillectomy in Children With Sleep-Disordered Breathing
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives. To investigate longitudinal changes in behavior and quality-of-life (QoL) in children with sleep disordered breathing (SDB) after adenotonsillectomy (AT). Methods. This study prospectively enrolled 148 children who underwent AT for SDB. Caregivers filled out Korean attention deficit hyperactivity disorder (ADHD) rating scale (K-ARS) and Korean version of the obstructive sleep apnea-18 (KOSA-18) at preoperative 1 day, postoperative 1 month, and postoperative 6 months. Longitudinal changes in K-ARS and KOSA-18 were evaluated and compared among subgroups. Results. Both K-ARS and KOSA-18 scores improved immediately at postoperative 1 month and were maintained at postoperative 6 months. The mean preoperative K-ARS scores of the non-ADHD, ADHD-trait, and overt-ADHD groups showed uniformly immediate and sustained improvements. Also, the mean preoperative KOSA-18 scores of the small, moderate, and large impact groups were significantly improved both at postoperative 1 month and 6 months. The changes in behavior and QoL showed no significant differences with regard to the aforementioned factors. Conclusion. After AT, we may expect immediate and sustained improvements in behavior and QoL in children with SDB regardless of preoperative symptom severity. Moreover, by performing AT, improvements in behavior and QoL are expected regardless of sex, age, allergic trait, or concurrent coblation-assisted turbinoplasty. These findings may help our colleague physicians counselling pediatric SDB patients and their caregivers.
Abstract
Objectives. To investigate longitudinal changes in behavior and quality-of-life (QoL) in children with sleep disordered breathing (SDB) after adenotonsillectomy (AT). Methods. This study prospectively enrolled 148 children who underwent AT for SDB. Caregivers filled out Korean attention deficit hyperactivity disorder (ADHD) rating scale (K-ARS) and Korean version of the obstructive sleep apnea-18 (KOSA-18) at preoperative 1 day, postoperative 1 month, and postoperative 6 months. Longitudinal changes in K-ARS and KOSA-18 were evaluated and compared among subgroups. Results. Both K-ARS and KOSA-18 scores improved immediately at postoperative 1 month and were maintained at postoperative 6 months. The mean preoperative K-ARS scores of the non-ADHD, ADHD-trait, and overt-ADHD groups showed uniformly immediate and sustained improvements. Also, the mean preoperative KOSA-18 scores of the small, moderate, and large impact groups were significantly improved both at postoperative 1 month and 6 months. The changes in behavior and QoL showed no significant differences with regard to the aforementioned factors. Conclusion. After AT, we may expect immediate and sustained improvements in behavior and QoL in children with SDB regardless of preoperative symptom severity. Moreover, by performing AT, improvements in behavior and QoL are expected regardless of sex, age, allergic trait, or concurrent coblation-assisted turbinoplasty. These findings may help our colleague physicians counselling pediatric SDB patients and their caregivers.
참고문헌 (20)
- De Serres LM., "Impact of adenotonsillectomy on quality of life in children with obstructive sleep disorders", Arch Otolaryngol Head Neck Surg, 128(5), pp.489~496 (2002)
- Spruyt K., "Sleep disturbances in children with attention-deficit", hyperactivity disorder, 2011, pp.11(4), 565~577
- Huang YS., "Attention-deficit", hyperactivity disorder with obstructive sleep apnea : a treatment outcome study, 2007, pp.8(1), 18~30
- Bhattacharjee R., "Adenotonsillectomy outcomes in treatment of obstructive sleep apnea in children : a multicenter retrospective study", Am J Respir Crit Care Med, 182(5), pp.676~683 (2010)
- Wei JL., "Improved behavior and sleep after adenotonsillectomy in children with sleep-disordered breathing : long-term follow-up", Arch Otolaryngol Head Neck Surg, 135(7), pp.642~646 (2009)
- Baldassari CM., "Pediatric obstructive sleep apnea and quality of life : a meta-analysis", Otolaryngol Head Neck Surg, 138(3), pp.265~273 (2008)
- Mitchell RB., "Long-term changes in behavior after adenotonsillectomy for obstructive sleep apnea syndrome in children", Otolaryngol Head Neck Surg, 134(3), pp.374~378 (2006)
- McColley SA., "High prevalence of allergic sensitization in children with habitual snoring and obstructive sleep apnea", Chest, 111(1), pp.170~173 (1997)
- Yoo HJ., "Attention deficit hyperactivity symptoms and internet addiction", Psychiatry Clin Neurosci, 58(5), pp.487~494 (2004)
- DuPaul GJ., "ADHD rating scale-IV: checklists, norms, and clinical interpretation" (1998), Guilford Press
- Katic A., "Treatment outcomes with lisdexamfetamine dimesylate in children who have attention-deficit", hyperactivity disorder with emotional control impairments, 2013, pp.23(6), 386~393
- Hwang SH., "Usefulness of adenotonsillar size for prediction of severity of obstructive sleep apnea and flow limitation", Otolaryngol Head Neck Surg, 149(2), pp.326~334 (2013)
- Fischer Y., "Long term change in quality of life after adenotonsillectomy for pediatric obstructive sleep disorders", Laryngorhinootologie, 85(11), pp.809~818 (2006)
- Franco RA Jr., "First place: resident clinical sci-ence award 1999. Quality of life for children with obstructive sleep apnea", Otolaryngol Head Neck Surg, 123(1 Pt 1), pp.9~16 (2000)
- Mitchell RB., "Child behavior after adenotonsillectomy for obstructive sleep apnea syndrome", Laryngoscope, 115(11), pp.2051~2055 (2005)
- Li HY., "Impact of adenotonsil-lectomy on behavior in children with sleep-disordered breathing", Laryngoscope, 116(7), pp.1142~1147 (2006)
- Friedman BC., "Adenotonsillectomy improves neurocog-nitive function in children with obstructive sleep apnea syndrome", Sleep, 26(8), pp.999~1005 (2003)
- Dillon JE., "DSM-IV diagnoses and obstructive sleep apnea in chil-dren before and 1 year after adenotonsillectomy", J Am Acad Child Adolesc Psychiatry, 46(11), pp.1425~1436 (2007)
- Strocker AM., "Parental understanding and attitudes of pediatric obstructive sleep apnea and adenotonsillectomy", Int J Pe-diatr Otorhinolaryngol, 71(11), pp.1709~1715 (2007)
- Cheng PW., "Improved objective out-comes and quality of life after adenotonsillectomy with inferior tur-binate reduction in pediatric obstructive sleep apnea with inferior turbinate hypertrophy", Laryngoscope, 122(12), pp.2850~2854 (2012)