ARCH. OTOLARYNGOL. HEAD NECK SURG. 126/4 (2000) 494-498


Impact of tonsillectomy and adenoidectomy on child behavior

Goldstein N.A., Post J.C., Rosenjeld R.M., Campbell T.F.

Division of Pediatric Otolaryngology, Stt. Univ. New York Hlth. Sci. Ctr., Brooklyn, NY, USA

Abstract
Objective: To measure the impact of tonsillectomy and adenoidectomy (T and A) on children's behavioral and emotional problems using a standardized assessment. Design: Prospective study. Setting: Tertiary care children's hospital. Patients: Thirty-six children, aged 2 through 18 years, with symptoms of nighttime snoring, observed apneas, and daytime mouth breathing and physical examination results demonstrating 3+ or 4+ tonsils scheduled for T and A. Intervention: Parents completed a standard survey of their children's symptoms of sleep apnea and a standardized measure of children's competencies and problems, the Child Behavior Checklist for ages 2 through 3 years or 4 through 18 years, before T and A and 3 months postoperatively. Main Outcome Measure: The Child Behavior Checklist total problem score. Results: The preoperative Child Behavior Checklist total problem score was consistent with abnormal behavior for 10 children (28%). After T and A (n = 15), only 2 scores were abnormal, but the change was not statistically significant. In contrast, the mean total problem score was 7.5 points lower after surgery (95% confidence interval, 5.1-9.7), indicating a significant decrease (P < .001, matched t test). Conclusions: This pilot study demonstrates a high prevalence (28%) of abnormal behavior in children undergoing T and A for chronic upper airway obstruction. Scores on a standardized measure of behavior improve following T and A, but larger studies with increased statistical power are needed to clarify the degree of improvement and its clinical importance.


 

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