Child Behavior and Quality of Life Before and After Tonsillectomy and Adenoidectomy

OBJECTIVE To determine the relationship between child behavior and quality of life before and after tonsillectomy and adenoidectomy by means of a standardized assessment of child behavior, the Child Behavior Checklist (CBCL), and a validated quality-of-life survey of pediatric obstructive sleep apne...

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Published in:	Archives of otolaryngology, head & neck surgery Vol. 128; no. 7; pp. 770 - 775
Main Authors:	Goldstein, Nira A, Fatima, Mahnur, Campbell, Thomas F, Rosenfeld, Richard M
Format:	Journal Article Conference Proceeding
Language:	English
Published:	Chicago, IL American Medical Association 01-07-2002
Subjects:	Adenoidectomy - psychology Adolescent Biological and medical sciences Child Child Behavior Child Behavior Disorders - etiology Child Behavior Disorders - psychology Child, Preschool Female Follow-Up Studies Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics Humans Male Medical sciences Non tumoral diseases Otorhinolaryngology. Stomatology Quality of Life Recurrence Sleep Apnea Syndromes - psychology Sleep Apnea Syndromes - surgery Socioeconomic Factors Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the upper aerodigestive tract Surveys and Questionnaires Tonsillectomy - psychology Tonsillitis - psychology Tonsillitis - surgery Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology Human Postoperative Sleep apnea syndrome Prognosis Upper respiratory tract Obstruction Adenoidectomy Quality of life Tonsillitis Survey Treatment Tonsillectomy Surgery ENT disease Pharynx disease Adenoid enlargement Preoperative Child Comparative study Hypertrophy
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Summary:	OBJECTIVE To determine the relationship between child behavior and quality of life before and after tonsillectomy and adenoidectomy by means of a standardized assessment of child behavior, the Child Behavior Checklist (CBCL), and a validated quality-of-life survey of pediatric obstructive sleep apnea, the OSA-18. DESIGN Before-after study. SETTING Hospital-based pediatric otolaryngology practice in a metropolitan area. PARTICIPANTS Sixty-four children (mean [SD] age, 5.8 [3.1] years; 36 boys, 28 girls) who underwent tonsillectomy and adenoidectomy for treatment of sleep-disordered breathing or recurrent tonsillitis. INTERVENTION Parents or caretakers completed the OSA-18 and the CBCL for ages 2 to 3 years or 4 to 18 years before surgery and 3 months postoperatively. MAIN OUTCOME MEASURES The OSA-18 mean survey scores and change scores, and the CBCL total problem T scores and change in total problem T scores. RESULTS The mean (SD) preoperative OSA-18 score was 3.9 (1.5) and change score was 2.3 (95% confidence interval, 1.9-2.7). The mean total problem score was 7.3 points lower after surgery (95% confidence interval, 4.9-9.7), indicating a significant decrease (P<.001, matched t test). The preoperative CBCL total problem score was consistent with abnormal behavior for 16 children (25%), but only 5 children (8%) scored in the abnormal range postoperatively (P = .03, log-likelihood ratio test). The OSA-18 preoperative mean survey score had fair to good correlation with the preoperative CBCL total problem T score (r = 0.50, P<.001, Pearson correlation), and the OSA-18 change score had fair to good correlation with the change in CBCL total problem T score (r = 0.54, P<.001, Pearson correlation). CONCLUSIONS Behavioral and emotional difficulties are found in children with sleep-disordered breathing before treatment and improve after intervention. Scores on a standardized measure of assessment of behavior demonstrate significant correlation with scores on a validated quality-of-life instrument.Arch Otolaryngol Head Neck Surg. 2002;128:770-775-->
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0886-4470 2168-6181 1538-361X 2168-619X
DOI:	10.1001/archotol.128.7.770