Adenotonsillectomy for Childhood Sleep Apnea
Author: Michele Reed, PharmD, RPh
A recently published study evaluated the effect of early adenotonsillectomy on polysomnographic, cognitive, behavioral, and health outcomes assessed over a 7-month period.1
A total of 464 children aged 5 to 9 years with obstructive sleep apnea syndrome were randomized to a strategy of watchful waiting or early adenotonsillectomy, and outcomes were assessed at baseline and at 7 months. The primary outcome was the attention and executive-function score on the Developmental Neuropsychological Assessment.
Results showed no significant change from baseline to follow-up for the primary outcome of attention and executive-function score (mean [±SD] improvement, 7.1 ± 13.9 in the early-adenotonsillectomy group, and 5.1 ± 13.4 in the watchful-waiting group; P = .16).
Significant improvements were demonstrated in the secondary end points of behavior, quality of life, polysomnographic findings, and reduction in symptoms in the early-adenotonsillectomy group compared with the watchful-waiting group. The authors concluded that the study demonstrates beneficial effects of early adenotonsillectomy with regard to behavior, quality of life, and polysomnographic findings; however, early adenotonsillectomy did not significantly improve attention or executive function as measured by neuropsychological testing.
Dr. Reed is a freelance writer in Fairless Hills, Pennsylvania.
Marcus CL, Moore RH, Rosen CL, et al. A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med. 2013;368(25):2366-2376.
Leuppi JD, Schuetz P, Bingisser R, et al. Short-term vs conventional glucocorticoid therapy in acute exacerbations of chronic obstructive pulmonary disease: the REDUCE randomized clinical trial. JAMA. 2013;309(21):2223-2231.
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