Assessing the need for adenotonsillectomy for sleep-disordered breathing in a community setting: A secondary outcome measures analysis of a randomized controlled study.

摘要: OBJECTIVE To assess whether children with sleep-disordered breathing (SDB) symptom severity above a certain level, measured by validated questionnaire, improve after adenotonsillectomy (AT) compared to no intervention. METHODS Children snoring and tonsillar hypertrophy (4 10-years old), who were candidates for AT, randomly assigned two evaluation sequences (baseline 3-month follow-up): (a) immediately before AT at 3 months postoperatively (AT group); or (b) the initial visit end of usual waiting period surgery (control group). Outcomes Pediatric Sleep Questionnaire sleep-related disorder scale (PSQ-SRBD); modified Epworth Sleepiness Scale (mESS); (c) proportion subjects achieving PSQ-SRBD <0.33 (low-risk apnea-hypopnea index ≥5/h) if they had score ≥0.33 baseline. RESULTS Sixty-eight 72 control group two-thirds them ≥0.33. The experienced significantly larger improvement between follow-up baseline than controls (between-group difference [95% CI] PSQ-SRBD: -0.31 [-0.35 -0.27]; mESS: -2.76 [-3.63 -1.90]; P < .001 both). in an eight-times higher probability similar (risk ratio CI]: 8.33 [3.92-17.54]; P < .001). CONCLUSION Among snoring, hypertrophy, clinical indications those preoperative show measurable benefit postoperatively.