Dong-Kyu Kim1, Doo Hee Han2. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea. 2. Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.
Abstract
BACKGROUND: Adenotonsillar hypertrophy is an undisputed major contributor to the development of pediatric sleep-disordered breathing (SDB). However, some children with SDB have experienced a worsening of quality of life (QOL) after adenotonsillectomy. The purpose of this study was to identify the factors of deteriorating QOL after adenotonsillectomy. METHODS: This was an observational cohort study at a single institute and consisted of 70 children with SDB who underwent adenotonsillectomy. The QOL was evaluated using the 18-item quality-of-life survey for obstructive sleep apnea (OSA-18) prior to surgery (S1), and at 1 month (S2), 6 months (S3), and 12 months (S4) postoperatively. Deterioration of QOL was defined as an increase in total scores of S3 and/or S4 by more than 25% of those on S2. Patients were categorized into rhinitis/nonrhinitis and atopy/non-atopy using the nasal symptom questionnaire and skin-prick test, respectively. RESULTS: The mean total scores of S2 and S4 were significantly lower than those of S1 (p < 0.001); however, some patients (n = 27, 38.6%) experienced an increase in scores. Patients with worsened QOL showed higher total immunoglobulin E (IgE) levels (p = 0.034) and complained of a rhinitis symptom more frequently (p = 0.039). Children with atopy were more likely to experience deterioration of QOL than those without (p = 0.004). In addition, multivariate logistic regression analysis showed that allergic rhinitis (AR) was a predictor for deterioration of QOL. CONCLUSION: This study suggests that AR may be a risk factor for deterioration of long-term QOL after adenotonsillectomy. Therefore, preoperative evaluation and proper management of AR might be considered in pediatric SDB.
BACKGROUND:Adenotonsillar hypertrophy is an undisputed major contributor to the development of pediatric sleep-disordered breathing (SDB). However, some children with SDB have experienced a worsening of quality of life (QOL) after adenotonsillectomy. The purpose of this study was to identify the factors of deteriorating QOL after adenotonsillectomy. METHODS: This was an observational cohort study at a single institute and consisted of 70 children with SDB who underwent adenotonsillectomy. The QOL was evaluated using the 18-item quality-of-life survey for obstructive sleep apnea (OSA-18) prior to surgery (S1), and at 1 month (S2), 6 months (S3), and 12 months (S4) postoperatively. Deterioration of QOL was defined as an increase in total scores of S3 and/or S4 by more than 25% of those on S2. Patients were categorized into rhinitis/nonrhinitis and atopy/non-atopy using the nasal symptom questionnaire and skin-prick test, respectively. RESULTS: The mean total scores of S2 and S4 were significantly lower than those of S1 (p < 0.001); however, some patients (n = 27, 38.6%) experienced an increase in scores. Patients with worsened QOL showed higher total immunoglobulin E (IgE) levels (p = 0.034) and complained of a rhinitis symptom more frequently (p = 0.039). Children with atopy were more likely to experience deterioration of QOL than those without (p = 0.004). In addition, multivariate logistic regression analysis showed that allergic rhinitis (AR) was a predictor for deterioration of QOL. CONCLUSION: This study suggests that AR may be a risk factor for deterioration of long-term QOL after adenotonsillectomy. Therefore, preoperative evaluation and proper management of AR might be considered in pediatric SDB.
Authors: Sarah K Wise; Sandra Y Lin; Elina Toskala; Richard R Orlandi; Cezmi A Akdis; Jeremiah A Alt; Antoine Azar; Fuad M Baroody; Claus Bachert; G Walter Canonica; Thomas Chacko; Cemal Cingi; Giorgio Ciprandi; Jacquelynne Corey; Linda S Cox; Peter Socrates Creticos; Adnan Custovic; Cecelia Damask; Adam DeConde; John M DelGaudio; Charles S Ebert; Jean Anderson Eloy; Carrie E Flanagan; Wytske J Fokkens; Christine Franzese; Jan Gosepath; Ashleigh Halderman; Robert G Hamilton; Hans Jürgen Hoffman; Jens M Hohlfeld; Steven M Houser; Peter H Hwang; Cristoforo Incorvaia; Deborah Jarvis; Ayesha N Khalid; Maritta Kilpeläinen; Todd T Kingdom; Helene Krouse; Desiree Larenas-Linnemann; Adrienne M Laury; Stella E Lee; Joshua M Levy; Amber U Luong; Bradley F Marple; Edward D McCoul; K Christopher McMains; Erik Melén; James W Mims; Gianna Moscato; Joaquim Mullol; Harold S Nelson; Monica Patadia; Ruby Pawankar; Oliver Pfaar; Michael P Platt; William Reisacher; Carmen Rondón; Luke Rudmik; Matthew Ryan; Joaquin Sastre; Rodney J Schlosser; Russell A Settipane; Hemant P Sharma; Aziz Sheikh; Timothy L Smith; Pongsakorn Tantilipikorn; Jody R Tversky; Maria C Veling; De Yun Wang; Marit Westman; Magnus Wickman; Mark Zacharek Journal: Int Forum Allergy Rhinol Date: 2018-02 Impact factor: 3.858