Study of quality of life outcome after adenotonsillectomy in children with sleep disorderd breathing

Authors

  • Arshed Ali Department of ENT, H&NS, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Jasif Nisar Department of ENT, H&NS, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Ihsan Ali Department of ENT, H&NS, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Rauf Ahmad Department of ENT, H&NS, Government Medical College, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20175156

Keywords:

SDB, OSA-18, Adenotonsillectomy

Abstract

Background: This prospective study was conducted in our department with the objective to study the quality of life outcome after adenotonsillectomy in children with sleep disorderd breathing. Sleep-disordered breathing, can lead to substantial morbidities, affecting the central nervous system (CNS), the cardiovascular and metabolic systems, and somatic growth, ultimately leading to reduced quality of life.

Methods: This prospective study was conducted in 47 patients in the Department of Otorhinolaryngology Head and Neck Surgery, Government Medical College and associated SMHS Hospital Srinagar. The study was included the patients with SDB in pediatric age group, who visited in our OPD.OSA-18 questionnaire was used pre-operatively, at 2 and 6 months after surgery.  

Results: Our study groups comprised of total 47 patients with majority of patients with in age group of 5-7 years, males were 29 (61.70%) and females were 18 (38.30%). In our study the OSA 18 scale used pre-operatively showed majority of patients 33 (70.21%) having score >80 score, with mean OSA-18 score of 84.15 showing that there was a major impact on quality of life and there was significant improvement in mean OSA-18 score in postoperative period from 30.49 to 26.85 at 2 and 6 months post- operatively and hence improvement in quality of life.

Conclusions: Based on the observation made in the study we concluded that there was a significant improvement in the disease specific postoperative quality of life after both adenotonsillectomy and tonsillectomy. We also concluded that polysomnography results matched with OSA 18 questionnaire scale score done preoperatively.

Author Biography

Arshed Ali, Department of ENT, H&NS, Government Medical College, Srinagar, Jammu and Kashmir, India

DEPARTMENT OF OTORHINOLARYNGOLOGY AND HEAD AND NECK SURGERY

References

Guilleminault C, Pelayo R, Leger D, Clerk A, Bocian RC. Recognition of sleep-disordered breathing in children. Pediatrics. 1996;98:871–82.

Coleman JA. Pathophysiology of snoring and obstructive sleep apnea: airway dynamics. In: Fairbanks DNK, Mickelson SA, Woodson BT, eds. Snoring and Obstructive Sleep Apnea. 3rd ed. Philadelphia: Williams & Wilkins Co.; 2003: 19.

Ali NJ, Pitson DJ. Snoring, Sleep disturbance, and behavior in 4-5 year olds. Arch Dis Child. 1993;68:360-6.

Redline S, Tishler PV, Schluchter M, Aylor J, Clark K, Graham G. Risk factors for sleep disordered breathing in children: associations with obesity, race, and respiratory problems. Am J Respir Crit Care Med. 1999;159:1527-32.

American Thoracic Society. Standard and indications for Cardiopulmonary sleep studies in children. Am J Respir Crit Care Med. 1996;153:866-78.

Arens R, Marcus CL. Pathophysiology of upper airway obstruction:a developmental perspective. Sleep. 2004;27:997-1019.

Guilleminault C, Korobkin R, Winkle R. A review of 50 children with obstructive sleep apnea syndrome. Lung. 1981;159:275–87.

Brouilette R, Hanson D, David R, Klemka L, Szatkowski A, Fernbach S, Hunt C. A diagnostic approach to suspected obstructive sleep apnea in children. J Pediatr. 1984;105:10–14.

Durr ML, Meyer AK, Kezirian EJ, Mamlouk MD, Frieden IJ, Rosbe KW. Sleep-Disordered Breathing in Pediatric Head and Neck Vascular Malformations. Laryngoscope. 2017;127(9):2159-64.

Guilleminault C, Korobkin R, Winkle R. A review of 50 children with obstructive sleep apnea syndrome. Lung. 1981;159:275–87.

Brouilette R, Hanson D, David R, Klemka L, Szatkowski A, Fernbach S, et al. A diagnostic approach to suspected obstructive sleep apnea in children. J Pediatr. 1984;105:10–4.

Spruyt K, Gozal D. Pediatric sleep questionnaires as diagnostic or epidemiological tools: A review of currently available instruments. Sleep Medicine Reviews. 2011;15(1):19-32.

Shouldice RB, O’Brien LM, O’Brien C, de Chazal P, Gozal D, Heneghan C. Detection of obstructive sleep apnea in pediatric subjects using surface lead electrocardiogram features. Sleep. 2004;27:784–92.

Section on Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome. American Academy of Pediatrics. Clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2002;109:704–12.

Goldbart AD, Tal A. Inflammation and sleep disordered breathing in children:a state-of-the-art review. Pediatr Pulmonol. 2008;43:1151–60.

Cardiorespiratory sleep studies in children. Establishment of normative data and polysomnographic predictors of morbidity, American Thoracic Society. Am J Respir Crit Care Med. 1999;160:1381.

de Lima Jr JM, da Silva VC, de Freitas MR. Long term results in the life quality of children with obstructive sleep disorders Rev Bras Otorrinolaringol. 2008;74(5):718-24.

Ron B. Kelly MJ. Outcomes and Quality of life following Adenotonsillectomy for sleep-dis0rdered breathing in children. ORL. 2007;69:345-8.

Flanary VA. Long-Term Effect of Adenotonsillectomy on Quality of Life in Pediatric Patients. Laryngoscope. 2003;113:1639-44.

Leach J, Olson J, Hermann J, Manning S. Polysomnographic and clinical findings in children with obstructive sleep apnea. Arch Otolaryngol Head Neck Surg. 1992;118(7):741-4.

Reilly JS. Apnéia obstrutiva do sono e ronco em crianças: noções gerais. Em: Sih T, Chinski A, Eavey R, editores. III Manual de Otorrinolaringologia Pediátrica da IAPO; 2003: 59-66.

Messner AH, Pelayo R. Pediatric sleep-related breathing disorders. Am J Otolaryngol. 2000;21(2):98-107.

Weckx LLM, Weckx LY. Respirador bucal: causas e conseqüências. Rev Bras Med. 1995;52(8):863-74.

Brooks LJ. Treatment of otherwise normal children with obstructive sleep apnea. Ear Nose Throat J. 1993;72(1):77-9.

Potsic WP, Pasquariello PS, Baranak CC, Marsh RR, Miller LM. Relief of upper airway obstruction by adenotonsillectomy. Otolaryngol Head Neck Surg. 1986;94(4):476-80.

Shintani T, Asakura K, Kataura A. The effect of adenotonsillectomy in children with OSA. Int J Pediatr Otorhinolaringol. 1998;44(1):51-8.

Stradling JR, Thomas G, Warley AR, Williams P, Freeland A. Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance and symptoms in snoring children. Lancet. 1990;335(8684):249-53.

Franco RA Jr, Rosenfeld RM, Rao M. First place resident clinical science award 1999. Quality of life for children with obstructive sleep apnea. Otolaryngol Head Neck Surg. 2000;123(1):9-16.

Stewart MG, Friedman EM, Sulek M, Hulka GF, Kuppersmith RB, Harrill WC, et al. Quality of life and health status in pediatric tonsil and adenoid disease. Arch Otolaryngol Head Neck Surg. 2000;126(1):458.

De Serres LM, Derkay C, Astley S, Deyo RA, Rosenfeld RM, Gates GA. Measuring quality of life in children with obstructive sleep disorders. Arch Otolaryngol Head Neck Surg. 2000;126(12):1423-9.

De Serres LM, Derkay C, Sie K, Biavati M, Jones J, Tunkel D, et al. Impact of adenotonsillectomy on quality of life in children with obstructive sleep disorders. Arch Otolaryngology Head Neck Surg. 2002;128(5):489-96.

Goldstein NA, Fatima M, Campbell TF, Rosenfeld RM. Child behavior and quality of life before and after tonsillectomy and adenoidectomy. Arch Otolaryngol Head Neck Surg. 2002;128(7):770-5.

Sohn H, Rosenfeld RM. Evaluation of sleep-disordered breathing in children. Otolaryngol Head Neck Surg. 2003;128(3):344-52.

Ishman SL. The role of sleep studies in children who snore. JAMA Otolaryngol Head Neck Surg. 2016;142(2):179-81.

Bixler EO, Vgontzas AN, Lin HM, Liao D, Calhoun S, Vela-Bueno A, et al. Sleep-disordered breathing in children in a general population sample: prevalence and risk factors. Sleep. 2009;32:731–6.

Schecter MS. American Academy of Pediatrics, Section on Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome. Technical report: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2002;109:69–88.

Brietzke SE, Katz ES, Roberson DW. Can history and physical examination reliably diagnose pediatric obstructive sleep apnea/hypopnea syndrome? A systematic review of the literature. Otolaryngol Head Neck Surg. 2004;131:827–32.

Carroll JL, McColley SA, Marcus CL, Curtis S, Loughlin GM. Inability of clinical history to distinguish primary snoring from obstructive sleep apnea syndrome in children. Chest. 1995;108:610–8.

Goldstein NA, Sculerati N, Walsleben JA, Bhatia N, Friedman DM, Rapoport DM. Clinical diagnosis of pediatric obstructive sleep apnea validated by polysomnography. Otolaryngol Head Neck Surg. 1994;111:611–7.

Leach J, Olson J, Hermann J, Manning S. Polysomnographic and clinical findings in children with obstructive sleep apnea. Arch Otolaryngol Head Neck Surg. 1992;118:741–4.

Suen JS, Arnold, JE, Brooks LJ. Adenotonsillectomy for treatment of obstructive sleep apnea in children. Arch Otolaryngol Head Neck Surg. 1995;121:525–30.

Wang RC, Elkins TP, Keech D. Wauquier A, Hubbard D. Accuracy of clinical evaluation in pediatric obstructive sleep apnea. Otolaryngol Head Neck Surg. 1998;118:69–73.

Franco RA, Rosenfeld RM, Rao M. Quality-of-life for children with obstructive sleep apnea. Otolaryngol Head Neck Surg. 2000;123:9–16.

Downloads

Published

2017-12-22

Issue

Section

Original Research Articles