Quality of life after adenotonsillectomy in children with obstructive sleep apnea: Short-term and long-term results

Objective: To assess short-term and long-term changes in quality of life after adenotonsillectomy (T&A) in children with obstructive sleep apnea (USA). Materials and methods: Children aged 2-18 years old were enrolled. All subjects had clinical symptoms, overnight polysomnography diagnosis of USA, and received T&A as treatment. Caregivers were asked to complete the OSA-18 survey before surgery, within 6 months after surgery (short-term), and more than 6 months after surgery (long-term). Results: A total of 114 children were included (mean age, 7.0 +/- 3.5 years; 75% boys). The mean OSA-18 total score was 71.5 +/- 16.0 before surgery. After surgery, the mean OSA-18 total score was significantly decreased in both the short-term (40.3 +/- 12.2, p<0.001) and the long-term (42.0 +/- 13.7, p<0.001). All five OSA-18 domains were also significantly decreased during short-term and long-term postoperative follow up (p < 0.001). Short-term and long-term outcomes were compared. Mean OSA-18 total scores, sleep disturbance score, emotional distress score, daytime function score, and caregiver concerns score did not differ significantly between the short-term and long-term periods, while the physical symptom score was slightly higher in the long-term than the short-term period (9.7 +/- 3.3 vs. 8.7 +/- 3.0, p = 0.02). Additionally, the physical symptoms score was higher in the long-term period in the female (p = 0.01), older age (>6 years) (p = 0.03), and non-obese (p = 0.04) subgroups. Conclusion: T&A improves short-term and long-term quality of life in children with USA. Nevertheless, caregivers observed children with aggravation of physical symptoms of quality of life during long-term follow up, especially in the female, older, and non-obese subgroups. (C) 2014 Elsevier Ireland Ltd. All rights reserved.