Randomised trial showed no difference in behavioural symptoms between surgical methods treating paediatric obstructive sleep apnoea

Abstract

Aim Our previous randomised controlled trial of children with obstructive sleep apnoea (OSA) showed no significant differences between adenotonsillectomy (ATE) and adenotonsillotomy (ATT) in improving nocturnal respiration and quality of life after 1 year. The aim of this report was to evaluate the effects on behavioural symptoms using the Strengths and Difficulties Questionnaire (SDQ). Methods Children between 2 and 6 years with OSA were randomised to ATT or ATE. Parents, blinded to method, answered the SDQ while their child underwent polysomnography before and 1 year after surgery. Differences between the total SDQ scores were analysed between the treatment groups. Results The SDQ was filled out in 87% of the cases preoperatively, and in 86% postoperatively. At follow‐up, the mean total SDQ score was 9.6 SD ± 5.1 in the ATE group (n = 31), and 8.2 ± 6.7 in the ATT group (n = 37), P = .09. The mean total SDQ score for all was preoperatively 10.6 ± 5.0, and postoperatively 8.8 ± 6.0, P = .0002. Conclusion There were no significant differences in SDQ scores between the groups at follow‐up, indicating that the more conservative ATT is a treatment option in paediatric OSA. The whole group of patients showed a significant improvement after surgery.

Recent advances in paediatric sleep disordered breathing

“…A smaller study of 162 children showed better pain scores in those with ICT versus those with TT, with no revision surgery in the ICT group [47]. ICT and TT showed similar behavioural outcome improvement [48]. ICT also appears to be effective in children with comorbidities associated with difficult-to-treat OSA.…”