Impact of allergic rhinitis on quality of life after adenotonsillectomy for pediatric sleep-disordered breathing

BackgroundAdenotonsillar hypertrophy is an undisputed major contributor to the development of pediatric sleep-disordered breathing (SDB). However, some children with SDB have experienced a worsening of quality of life (QOL) after adenotonsillectomy. The purpose of this study was to identify the factors of deteriorating QOL after adenotonsillectomy. MethodsThis was an observational cohort study at a single institute and consisted of 70 children with SDB who underwent adenotonsillectomy. The QOL was evaluated using the 18-item quality-of-life survey for obstructive sleep apnea (OSA-18) prior to surgery (S1), and at 1 month (S2), 6 months (S3), and 12 months (S4) postoperatively. Deterioration of QOL was defined as an increase in total scores of S3 and/or S4 by more than 25% of those on S2. Patients were categorized into rhinitis/nonrhinitis and atopy/non-atopy using the nasal symptom questionnaire and skin-prick test, respectively. ResultsThe mean total scores of S2 and S4 were significantly lower than those of S1 (p < 0.001); however, some patients (n = 27, 38.6%) experienced an increase in scores. Patients with worsened QOL showed higher total immunoglobulin E (IgE) levels (p = 0.034) and complained of a rhinitis symptom more frequently (p = 0.039). Children with atopy were more likely to experience deterioration of QOL than those without (p = 0.004). In addition, multivariate logistic regression analysis showed that allergic rhinitis (AR) was a predictor for deterioration of QOL. ConclusionThis study suggests that AR may be a risk factor for deterioration of long-term QOL after adenotonsillectomy. Therefore, preoperative evaluation and proper management of AR might be considered in pediatric SDB.