Quality of Life in Under-14-Year-Old Children After Adenotonsillectomy

Document Type : Original

Authors

Department of otorhinolaryngology, Hamedan University of Medical Sciences, Hamedan, Iran

Abstract

Introduction:
Tonsillectomy with or without adenoidectomy is one of the most frequent surgical procedures especially in children. Several indications and contraindications have been suggested for this procedure. The benefits and the negative results of this operation have been studied by different researchers; nevertheless, to date, it is still a common procedure.
The main purpose of this study is to obtain extensive information on the outcomes of adenotonsillectomy, according to the patient's physical, emotional and behavioral changes and also on the overall changes in his/her quality of life (QOL).
Materials and Methods:
All the children, aged 1-14, referred to the Besat Hospital clinics (Hamadan, Iran) between March 2008 and March 2009 were included in this study. Overall, 86 children with documented indications underwent adenotonsillectomy, and were followed up for one year.  Two modified standard questionnaires for QOL were completed before and one year after the tonsillectomy. Upon the completion of this two-year study, statistical analyses were performed, and the demographic data of the study groups were compared with those of a same-age group.
Results:
Changes were observed in five main complaints as follow: Acute Recurrent tonsillitis was present in 86 patients preoperatively, but in only three cases postoperatively (pharyngitis). Confirmed chronic sinusitis was present in 24 patients preoperatively, but only in three cases during the year after the surgery. Oral breathing was seen in 82 patients preoperatively, but only in one patient during the year after the surgery. Nocturnal snoring was seen in 83 children preoperatively, but in 25 cases during the year after the surgery. Halitosis was present in 71 patients, while and halitosis was seen in 27 during the year after the surgery.
Conclusion:
Overall, the majority of the parameters studied showed significant differences after surgery.

Keywords


  1. Mui S, Rasgon BM, Hilsinger RI. Efficacy of tonsillectomy for recurrent throat infection in adults. Laryngoscope 1998; 108(9): 1325-8.
  2. Barr GS, Osborn G. Weight gain in children following tonsillectomy. J Laryngol Otol 1988; 102(7): 595-7.
  3. Goldstein NA, Fatima M, Campbell TF, Rosenfeld RM. Child behavior and quality of life before and after tonsillectomy and adenoidectomy. Arch Otolaryngol Head Neck Surg 2002; 128(7): 770-5.
  4. Witsell DL, Orvidas LJ, Stewart MG, Hannley MT. Quality of life after tonsillectomy in adults with recurrent or chronic tonsillitis. Otolaryngol Head Neck Surg 2008; 138(1): 1-8.
  5. Goldstein NA, Stewart MG, Witsell DL, Hannley MT. Quality of life after tonsillectomy in children with recurrent tonsillitis. Otlaryngol Head Neck Surg 2008; 138(1): 9-16.
  6. Tuncer U, Aydogan B, Soylu L. Chronic rhinosinusitis and adenoid hypertrophy in children. Am J Otolaryngol 2004; 25(1): 5-10.
  7. Ungkanont K, Damrongsak S. Effect of adenoidectomy in children with complex problems of rhinosinusitis and associated diseases. Inter J Ped Otorhinolaryngol 2004; 68(4): 447-51.
  8. Bonuk KA, Freeman K, Henderson J. Growth and growth biomarker changes after adenotosillectomy: Systematic review and meta-analysis. Arch Dis Child 2009; 94: 83-91.
  9. Garetz SL, Arbor A. Behavior, cognition, and quality of life after adenotosillectomy for pediatric sleep-disordered breathing: Summary of the literature. Otolarngol Head Neck Surg 2008; 138: 19-26.
  10. Stewart MG, Friedman EM, Sulek M. Validation of an outcomes instrument for tonsil and adenoid disease. Arch Otolaryngol Head Neck Surg 2001; 127: 29-35.
  11. Landgraf JM, Abetz L, Ware JE. Child health questionnaire (CHQ): A user's manual. 1st ed. Boston: The Health Institute, New England Medical Center; 1996: 125-46.
  12. Kiris M, Muderris T, Celebi S. Changes in serum IGF-1 and IGFBP-3 levels and growth in children following adenoidectomy, tonsillectomy or adenotonsillectomy. Inter J Pediatr Otolaryngol 2010; 74: 528-31.
  13. Mora R, Crippa B, Dellepiane M, Jankowska B. Effects of adenotonsillectomy on speech spectrum in children. Inter J Pediatr Otolaryngol 2007; 71: 1299-304.
  14. Weilder DJ., Hauri PJ. Nocturnal enuresis in children with upper airway obstruction. Inter J Pediatr Otolaryngol 1985; 9: 173-82.
  15. Weilder DJ, Sateia MJ, West RP. Nocturnal enuresis in children with upper airway obstruction. Otolaryngol Head Neck Surg 1991; 105: 427-32.
  16. Wolfensberger M, Haury JA, Linder T. Patient satisfaction 1 year after adenotonsillectomy of their children. Inter J Pediatr Otolaryngol 2000; 56: 199-205.
  17. Carr E, Obholzer R, Caulfield H. A prospective study to determine the incidence of atopy in children undergoing adenotonsillectomy for obstructive sleep apnea. Inter J Pediatr Otolaryngol 2007; 71: 19-22.
  18. Comen K, Rovers MM, Van den Akker E, Van Staaij B. Laryngoscope 2005; 115(4): 731-4.
  19. Holt GR, Tinsley PP. Peritonsillar abscessesin children. Laryngoscope 1981; 91(8): 1226-30.