Melhora da qualidade de vida em crianças após adenoamigdalectomia

Abstract

Enl arged palatine and pharyngeal tonsils is one of the most frequent occurrences in otorhinolaryngology, and it is the main cause of obstructive sleep apnea in children. Aim: To evaluate the impact of adenotonsillectomy in the quality of life of children with adenotonsillar hyperplasia. Study design: Clinical prospective. Material and Method: 36 parents/guardians of children who underwent adenotonsillectomy were interviewed, before and after surgery. We used a special Questionnaire about quality of life (developed by Serres et al. 2000), whose items included physical distress, sleep disorders, speech and swallowing disorders, emotional distress, limitation in activities and parent's/guardian's concern. Results: The quality of life of all children improved after surgery. There was direct association between the level of airway obstruction and sleep disorders, parent's/guardian's concern and average scores. Comparing the items, we found statistical association between emotional distress and sleep disorders; parent's/ guardian's concern and sleep disorders and limitation in activities and emotional distress. Conclusion: Enlarged tonsils and obstructive sleep apnea worsen the quality of life of children, especially because of physical distress and sleep disorders. Adenotonsillectomy greatly improves the quality of life of these patients.Key words: obstructive sleep apnea, adenotonsillectomy, quality of life. «««« ««««Rev Bras Otorrinolaringol.

Avaliação do impacto da adenotonsilectomia sobre a qualidade de vida em crianças com hipertrofia das tonsilas palatinas e faríngeas

“…The patients' parents or guardians were interviewed by means of a specific questionnaire -OSD-6, based on the work of Di Fransesco et al 7 ( Figure 1), one day before and one month after the surgery, after they were duly informed about the study and signed the Free and Informed Consent. Such questionnaire included the following domains: physical suffering (1), sleep disorder (2), speech and swallowing disorders (3), emotional discomfort (4), physical activity limitations (5) and concerns from parents and guardians about the child's snoring (6) and there are three legends that serve to quantify each item on the domains, in other words, how the guardians believe the symptoms affect their children.…”

“…Not treating children with this disorder can bring about a number of problems: low school performance, non-specific behavior disorders, lack of attention, development delays, problems with mastication and swallowing, oral breathing and its craniofacial repercussions, day sleepiness, enuresis, cor pulmonale and height-weight deficit 5,6 . Symptoms and complications caused by upper airway obstruction lead to a significant reduction in the quality of life of these patients 7 . There are some treatment possibilities such as CPAP (Continuous Positive Airway Pressure) and weight loss in obese patients; however, these alternatives are not well tolerated by children and are rarely adopted as primary treatment 8 .…”

“…The physical consequences in general, represent the greatest concerns physicians have regarding the disease's impact 7 . Nonetheless, the disease impact on the quality of life of patients and their guardians must also be taken into account when treatment choice is being considered.…”

Fonoaudiologia X ronco/apneia do sono

“…As principais consequências da SAOS em crianças são: problemas cardiovasculares: hipertensão pulmonar (decorrente de hipóxia e hipercapnia recorrentes), que pode levar à insu ciência cardí-aca congestiva e ao cor pulmonale (estas condições são muito raras na atualidade, e são reversíveis com a correção da SAOS); baixo desenvolvimento pôndero-estatural; neurocognitivos: problemas comportamentais (como hiperatividade, agressividade e agitação), diminuição na concentração, hipersonolência diurna (em crianças mais velhas) e baixo aprendizado na escola 14,28 . Dessa forma, a SAOS deve ser reconhecida e tratada precocemente, na tentativa de se evitar ou atenuar as suas consequências, tão deletérias ao desenvolvimento adequado da criança 31,33 .…”

Estudo das medidas pôndero-estaturais em crianças adenotonsilectomizadas

“…It is well known that children with obstructive tonsillar hyperplasia have a worsening in their quality of life. This is mainly due to obstructive sleep apnea which, for some authors, is the main morbidity associated 5 . A clinical daily observation, with scientific confirmation, allows us to establish a direct relationship between patients with adenotonsillar hyperplasia with the onset of weight and height gain deficit that gets worse when associated with obstructive sleep apnea and hypoapnea (OSAH).…”