Quality of life after combined adenoidectomy and laser tonsillotomy for pediatric sleep-disordered breathing: A prospective observational cohort trial.

INTRODUCTION

Tonsillotomy is an alternative to tonsillectomy with much less morbidity in case of tonsil surgery for pediatric sleep-disordered breathing (PSDB), but tonsillar disease-specific quality of life data conforming the effectiveness are sparse.

METHODS

A prospective observation study was conducted in children with PSDB undergoing laser (adeno)tonsillotomy. A German version Tonsil and Adenoid Health Status Instrument (TAHSI) for the children (G-TAHSI-c), for the parents (G-TAHSI-p), and the Tonsillectomy Outcome Inventory 14 (TOI-14) were measured before surgery (T0), 3 months (T3), and 6 months (T6) after surgery.

RESULTS

54 children (65 % male; median age: 4 years; 96.3 % combined adenotonsillotomy) were included. The G-TAHSI-c subdomains eating/swallowing, halitosis, work performance, and the total score improved significantly between T0 and T3 (all p < 0.05). The subdomains recurrent throat infections, chronic throat infections, lymphadenopathy, health utilization, and nocturnal breathing did not change significantly (all p > 0.05). The G-TAHSI-p subdomains chronic throat infections, eating and swallowing problems, halitosis, severe throat infections, and the total G-TAHSI-p improved (all p < 0.05). All subdomains but the TOI-14 subdomain social psychological restrictions and the total score improved significantly from T0 to T3 (all p < 0.05). A significant further change between T3 and T6 was not seen for G-TAHSI-c, G-TAHSI-p, and TOI-14 (all p > 0.05). Gender, age, and initial OSA-18 score had no influence on the quality of life improvement.

CONCLUSIONS

(Adeno)tonsillotomy leads to fast quality of life improvement in children with PSDB within 3 months after surgery.