Discrepancy between Objective and Subjective Outcomes after Adenotonsillectomy in Children with Obstructive Sleep Apnea Syndrome
© American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014..
OBJECTIVE: Adenotonsillectomy (T&A) is the first line therapy for pediatric obstructive sleep apnea (OSA); however, inconsistency between objective and subjective outcomes perplexes physicians. This study investigates changes of objective and subjective outcomes in children with OSA after T&A, in particular, to elucidate correlations and discrepancies between these 2 measures.
STUDY DESIGN: Case series with record review.
SETTING: Tertiary referral medical center.
SUBJECTS AND METHODS: Symptomatic children with polysomnographic diagnosis of OSA (apnea-hypopnea index [AHI] > 1) were included. All children underwent T&A to treat OSA, along with completely objective (polysomnography) and subjective (Obstructive Sleep Apnea 18-Item Quality-of-Life Questionnaire [OSA-18]) measures before and 3 months after surgery.
RESULTS: One hundred nineteen children were included (mean age, 6.9 ± 3.3 years; 76% boys). Adenotonsillectomy significantly reduced AHI from 15.4 ± 21.2 per hour to 1.6 ± 2.5 per hour (P < .001). The OSA-18 scores were significantly improved after surgery (P < .001). A weak but statistically significant positive correlation was found between AHI and OSA-18 scores preoperatively (ρ = 0.22, P = .016) but not postoperatively (ρ = 0.04, P = .677). Among those cases with residual OSA after surgery, only 6% (3/54) had a residual effect on quality of life (OSA-18 score > 60).
CONCLUSION: Adenotonsillectomy improves both objective and subjective outcomes. After surgery, quality of life significantly improved subjectively, despite an incomplete resolution of OSA objectively, leading to a better correlation between objective and subjective measures before as opposed to after surgery. Discrepancy between the 2 measures warrants an evaluation of a child both objectively and subjectively when treating OSA.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2014 |
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| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:151 |
|---|---|
| Enthalten in: |
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery - 151(2014), 1 vom: 19. Juli, Seite 150-8 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Kang, Kun-Tai [VerfasserIn] |
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| Links: |
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| Themen: |
Adenoidectomy |
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| Anmerkungen: |
Date Completed 06.11.2017 Date Revised 08.12.2017 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/0194599814529534 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM237106841 |
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| 100 | 1 | |a Kang, Kun-Tai |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Discrepancy between Objective and Subjective Outcomes after Adenotonsillectomy in Children with Obstructive Sleep Apnea Syndrome |
| 264 | 1 | |c 2014 | |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014. | ||
| 520 | |a OBJECTIVE: Adenotonsillectomy (T&A) is the first line therapy for pediatric obstructive sleep apnea (OSA); however, inconsistency between objective and subjective outcomes perplexes physicians. This study investigates changes of objective and subjective outcomes in children with OSA after T&A, in particular, to elucidate correlations and discrepancies between these 2 measures | ||
| 520 | |a STUDY DESIGN: Case series with record review | ||
| 520 | |a SETTING: Tertiary referral medical center | ||
| 520 | |a SUBJECTS AND METHODS: Symptomatic children with polysomnographic diagnosis of OSA (apnea-hypopnea index [AHI] > 1) were included. All children underwent T&A to treat OSA, along with completely objective (polysomnography) and subjective (Obstructive Sleep Apnea 18-Item Quality-of-Life Questionnaire [OSA-18]) measures before and 3 months after surgery | ||
| 520 | |a RESULTS: One hundred nineteen children were included (mean age, 6.9 ± 3.3 years; 76% boys). Adenotonsillectomy significantly reduced AHI from 15.4 ± 21.2 per hour to 1.6 ± 2.5 per hour (P < .001). The OSA-18 scores were significantly improved after surgery (P < .001). A weak but statistically significant positive correlation was found between AHI and OSA-18 scores preoperatively (ρ = 0.22, P = .016) but not postoperatively (ρ = 0.04, P = .677). Among those cases with residual OSA after surgery, only 6% (3/54) had a residual effect on quality of life (OSA-18 score > 60) | ||
| 520 | |a CONCLUSION: Adenotonsillectomy improves both objective and subjective outcomes. After surgery, quality of life significantly improved subjectively, despite an incomplete resolution of OSA objectively, leading to a better correlation between objective and subjective measures before as opposed to after surgery. Discrepancy between the 2 measures warrants an evaluation of a child both objectively and subjectively when treating OSA | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a adenoidectomy | |
| 650 | 4 | |a adenotonsillectomy | |
| 650 | 4 | |a child | |
| 650 | 4 | |a polysomnography | |
| 650 | 4 | |a quality of life | |
| 650 | 4 | |a sleep apnea syndromes | |
| 650 | 4 | |a tonsillectomy | |
| 700 | 1 | |a Weng, Wen-Chin |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Chia-Hsuan |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Pei-Lin |e verfasserin |4 aut | |
| 700 | 1 | |a Hsu, Wei-Chung |e verfasserin |4 aut | |
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