期刊
OTOLARYNGOLOGY-HEAD AND NECK SURGERY
卷 151, 期 1, 页码 150-158出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/0194599814529534
关键词
adenoidectomy; adenotonsillectomy; child; quality of life; sleep apnea syndromes; polysomnography; tonsillectomy
资金
- National Taiwan University Hospital [NTUH 102-S2193]
Objective. Adenotonsillectomy (T&A) is the first line therapy for pediatric obstructive sleep apnea (OSA); however, inconsistency between objective and subjective outcomes perplexes physicians. This study investigates changes of objective and subjective outcomes in children with OSA after T&A, in particular, to elucidate correlations and discrepancies between these 2 measures. Study Design. Case series with record review. Setting. Tertiary referral medical center. Subjects and Methods. Symptomatic children with polysomnographic diagnosis of OSA (apnea-hypopnea index [AHI] > 1) were included. All children underwent T&A to treat OSA, along with completely objective (polysomnography) and subjective (Obstructive Sleep Apnea 18-Item Quality-of-Life Questionnaire [OSA-18]) measures before and 3 months after surgery. Results. One hundred nineteen children were included (mean age, 6.9 +/- 3.3 years; 76% boys). Adenotonsillectomy significantly reduced AHI from 15.4 +/- 21.2 per hour to 1.6 +/- 2.5 per hour (P <. 001). The OSA-18 scores were significantly improved after surgery (P <. 001). A weak but statistically significant positive correlation was found between AHI and OSA-18 scores preoperatively (rho = 0.22, P = .016) but not postoperatively (rho = 0.04, P = .677). Among those cases with residual OSA after surgery, only 6% (3/54) had a residual effect on quality of life (OSA-18 score. 60). Conclusion. Adenotonsillectomy improves both objective and subjective outcomes. After surgery, quality of life significantly improved subjectively, despite an incomplete resolution of OSA objectively, leading to a better correlation between objective and subjective measures before as opposed to after surgery. Discrepancy between the 2 measures warrants an evaluation of a child both objectively and subjectively when treating OSA.
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