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Corrêa CDC, Piña SP, Evangelisti M, Villa MP, Weber SAT. Quality of the Italian Websites for Parental Guidance on the Indications for Tonsillectomy in Children. Int Arch Otorhinolaryngol 2021; 25:e446-e452. [PMID: 34377183 PMCID: PMC8321631 DOI: 10.1055/s-0040-1716569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 07/17/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction The quality of information on websites about tonsillectomy regarding the knowledge level may be low. Tonsillectomy is a surgical procedure to hypertrophy of the palatine and pharyngeal tonsils. So, it is an invasive procedure with possible complications, which creates insecurity in parents. Significantly, Internet searches have been increased to address possible health concerns, questioning the quality of websites about tonsillectomy. Objective To evaluate the readability, reliability, and comprehensiveness of the Italian websites dedicated to parental guidance regarding the indications for tonsillectomy in children. Methods The search engine google.it was used to search the websites. The Gulpease index, which is a widely used readability formula ranging from 0 (difficult) to 100 (easy readability), was employed to evaluate these websites. The Health on the Net Code of Conduct (HONcode) was used to assess the quality of information, by taking ethical principles into account, with values ranging from 0 to 13. The content comprehensiveness of the web pages was assessed by assigning points ranging from 1 (very insufficient) to 5 (very satisfying) to each page. A final comparison with previous studies on tonsillectomy published on websites from other countries was performed. Results Fourteen Italian websites were selected, and the Gulpease index showed a mean average of 40.77 ± 8.45. The mean of the HONcode analysis was 6.00 ± 1.92, in which the principles with the poorest scores were Attribution and Update . As far as the comprehensiveness of the websites is concerned, the resulting mean was 2.57 ± 0.77, in which Indications was the topic with the highest mean, whereas Benefits was the one with the lowest. Conclusion The Italian websites were characterized by a lower readability level, a middle position regarding ethical principles, and the same (insufficient) comprehensiveness of tonsillectomy when compared with websites from different countries.
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Affiliation(s)
- Camila de Castro Corrêa
- Graduation Course of Speech-Language and Hearing Pathology, Universidade de Brasília, Brasília, DF, Brazil
- Graduation Course of Speech-Language and Hearing Pathology, Centro Universitário Planalto do Distrito Federal (UNIPLAN), Brasília, DF, Brazil
| | - Sofia Prata Piña
- Department of Ophthalmology, Otolaryngology, and Head and Neck Surgery, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brazil
| | - Melania Evangelisti
- Pediatric Sleep Disease Center, Child Neurology, NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Maria Pia Villa
- Pediatric Sleep Disease Center, Child Neurology, NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Silke Anna Theresa Weber
- Department of Ophthalmology, Otolaryngology, and Head and Neck Surgery, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brazil
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Health Related Quality of Life T-14 Outcomes for Pediatric Bizact Tonsillectomy. ACTA ACUST UNITED AC 2021; 57:medicina57050480. [PMID: 34065868 PMCID: PMC8150773 DOI: 10.3390/medicina57050480] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/07/2021] [Indexed: 11/17/2022]
Abstract
Objectives: The objective of this study was to assess the T-14 outcomes of the BizactTM device for tonsillectomy in a pediatric population. Methods: A case series chart review was undertaken at a public tertiary teaching hospital and private otolaryngology practice, with data collected from pediatric patients who underwent a BizactTM tonsillectomy between July 2016 and October 2019 for any indication, whose parents consented to completing the T-14 questionnaire providing a parental perspective of the child's quality of life. Primary outcomes were T-14 scores recorded preoperatively and 6 weeks post-operatively. Secondary outcome measures were postoperative complications, including hemorrhage and readmission. Results: 146 patients were identified. There was a significant improvement in T-14 scores from a median of 24 (Interquartile range (IQR) 18-33) prior to surgery to 2 (IQR 0-4) at 6 weeks postoperatively (p < 0.001). The post-tonsillectomy hemorrhage rate was 6.1% (9/146 participants). Conclusions: Pediatric BizactTM tonsillectomy is effective in treating common indications for pediatric tonsillectomy, reflected by improved parent-reported health-related quality of life T-14 scores postoperatively.
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Kubala ME, Turner M, Gardner JR, Williamson A, Richter GT. Impact of Oral Steroids on Tonsillectomy Postoperative Complications and Pain. EAR, NOSE & THROAT JOURNAL 2021; 102:NP206-NP211. [PMID: 33734886 DOI: 10.1177/01455613211000832] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To analyze the impact of steroids on postoperative tonsillectomy recovery and implement findings for improvement in postoperative management. METHODS Institutional review board approved prospective study with retrospective analysis of private practice setting tonsillectomy patients (November 2015 to January 2017). A questionnaire was provided postoperatively to patients undergoing tonsillectomy with or without adenoidectomy. The study population was separated into 2 groups: patients who received steroids (3 days of either dexamethasone or prednisolone), postoperative steroid (POS), versus patients who did not receive steroids (PONS). RESULTS The questionnaire had a return rate of 27.3% (254/931). Nine of the 254 responses were disqualified for lack of information; therefore, the total number of responses was 245. Of these, 115 were POS and 130 were PONS. The groups were similar in mean age (POS: 13.2 ± 10.4 years, PONS: 14.7 ± 12.1 years, P = .32) and sex (POS: Male 40.0%, PONS: Male 40.0%, P = .97). There was an overall decrease of pain and nausea/vomiting (N/V) in the steroid group (P = .0007). There was reduction in pain (P < .05) from postoperative day (POD) 2, 3, 4, and 6 in the POS group. Otherwise, there was no significant reduction in pain from POD 7 to 14, day-by-day rate of N/V, bleeding, or rate of emergency department (ED) or clinic visit (P > .05). CONCLUSION Postoperative steroid reduced overall pain and N/V, as well as daily pain on POD 2, 3, 4, and 6. Pain from POD 7 to 14, rate of ED or clinic visit, or daily N/V and bleeding rate were not significantly different between cohorts.
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Affiliation(s)
- Michael E Kubala
- Department of Otolaryngology-Head and Neck Surgery, 12215University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Merit Turner
- Department of Otolaryngology-Head and Neck Surgery, 12215University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - James Reed Gardner
- Department of Otolaryngology-Head and Neck Surgery, 12215University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Adrian Williamson
- Department of Otolaryngology-Head and Neck Surgery, 12215University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Arkansas Otolaryngology Centers, Little Rock, AR, USA
| | - Gresham T Richter
- Department of Otolaryngology-Head and Neck Surgery, 12215University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Division of Pediatric Otolaryngology, Arkansas Children's Hospital, Little Rock, AR, USA
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Dorismond C, Farzal Z, Thompson NJ, Lee SE, Zdanski CJ. Readability analysis of pediatric otolaryngology patient-reported outcome measures. Int J Pediatr Otorhinolaryngol 2021; 140:110550. [PMID: 33316760 DOI: 10.1016/j.ijporl.2020.110550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/06/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE (s): Patient-reported outcome measures (PROMs) are tools that allow patients to directly share information about their health with their healthcare provider. Health literacy experts recommend that health information, such as PROMs, be written at a 6th grade level to ensure patients can read and comprehend it. As the readability of PROMs used in pediatric otolaryngology has yet to be studied, our goal was to analyze the readability of these PROMs and assess their compliance with readability recommendations. METHODS The Gunning Fog, the Simple Measure of Gobbledygook (SMOG), and the FORCAST readability formulas were used to determine the readability of disease-specific PROMs for pediatric otolaryngology. RESULTS Fourteen PROMs were reviewed in the study. Most were intended for caregiver completion (n = 13, 92.9%). Ten PROMs when measured by Gunning Fog (71.4%), 2 PROMs when measured by SMOG (14.3%), and 0 PROMs when measured by FORCAST (0.0%) were at or below the 6th grade reading level. CONCLUSION Most PROMs available for use in pediatric otolaryngology are above the recommended 6th grade reading level when measured by FORCAST, the most appropriate metric for assessing questionnaires. The high reading grade level needed to complete these PROMs can contribute to health disparities among underserved and vulnerable populations, such as children. Pediatric otolaryngology PROMs developed in the future should take readability into account in order to ensure equity in the delivery of care.
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Affiliation(s)
- Christina Dorismond
- University of North Carolina School of Medicine, 321 S Columbia St, Chapel Hill, NC, 27516, USA.
| | - Zainab Farzal
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, 170 Manning Drive, Campus Box #7070, Chapel Hill, NC, 27599, USA
| | - Nicholas J Thompson
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, 170 Manning Drive, Campus Box #7070, Chapel Hill, NC, 27599, USA
| | - Saangyoung E Lee
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, 170 Manning Drive, Campus Box #7070, Chapel Hill, NC, 27599, USA
| | - Carlton J Zdanski
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, 170 Manning Drive, Campus Box #7070, Chapel Hill, NC, 27599, USA
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Konieczny KM, Pitts-Tucker TN, Biggs TC, Pringle MB. A five-year follow-up observational study of the T-14 paediatric throat disorders outcome measure in tonsillectomy and adenotonsillectomy. Ann R Coll Surg Engl 2019; 101:40-43. [PMID: 30112941 PMCID: PMC6303835 DOI: 10.1308/rcsann.2018.0133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2018] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION The T-14 questionnaire is a validated outcome measurement tool to assess the value of paediatric tonsillectomy from a parent's perspective. There is a paucity of data regarding the long-term postoperative effects of tonsillectomy on quality of life in the paediatric population. Our previous study assessed T-14 scores up to year 2 postoperatively, with this study extending follow-up to 5 years. MATERIALS AND METHODS We undertook a prospective uncontrolled observational study examining 54 paediatric patients undergoing tonsillectomy at Portsmouth Hospitals NHS Trust. Parents of children undergoing surgery were invited to complete a T-14 questionnaire preoperatively, as well as at 3 months, 6 months, 1 year, 2 years and now 5 years postoperatively. RESULTS In total, 44 of 54 patients completed questionnaires preoperatively and at all postoperative time points, with 46 being completed at 5 years. There was a highly significant (P < 0.001) difference between the preoperative scores and all other measured T-14 scores postoperatively. The mean score preoperatively was 33.3 compared with 1.0 at 5 years. CONCLUSIONS This is the first study to assess long-term quality of life following paediatric tonsillectomy using the T-14 questionnaire. The benefits of tonsillectomy on long-term quality of life further confirms its value within the paediatric population.
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Affiliation(s)
- KM Konieczny
- Portsmouth Hospitals NHS Foundation Trust, Portsmouth, UK
| | - TN Pitts-Tucker
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - TC Biggs
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - MB Pringle
- Portsmouth Hospitals NHS Foundation Trust, Portsmouth, UK
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Powell J, Powell S, Robson A. A systematic review of patient-reported outcome measures in paediatric otolaryngology. J Laryngol Otol 2018; 132:2-7. [PMID: 29224575 DOI: 10.1017/s0022215117002420] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Recently, there has been increased emphasis on the development and application of patient-reported outcome measures. This drive to assess the impact of illness or interventions, from the patient's perspective, has resulted in a greater number of available questionnaires. The importance of selecting an appropriate patient-reported outcome measure is specifically emphasised in the paediatric population. The literature on patient-reported outcome measures used in paediatric otolaryngology was reviewed. METHODS A comprehensive literature search was conducted using the databases Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo, using the terms: 'health assessment questionnaire', 'structured questionnaire', 'questionnaire', 'patient reported outcome measures', 'PROM', 'quality of life' or 'survey', and 'children' or 'otolaryngology'. The search was limited to English-language articles published between 1996 and 2016. RESULTS The search yielded 656 articles, of which 63 were considered relevant. This included general paediatric patient-reported outcome measures applied to otolaryngology, and paediatric otolaryngology disease-specific patient-reported outcome measures. CONCLUSION A large collection of patient-reported outcome measures are described in the paediatric otolaryngology literature. Greater standardisation of the patient-reported outcome measures used in paediatric otolaryngology would assist in pooling of data and increase the validation of tools used.
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Affiliation(s)
- J Powell
- Department of Paediatric Otolaryngology,Great North Children's Hospital,Newcastle upon Tyne,UK
| | - S Powell
- Department of Paediatric Otolaryngology,Great North Children's Hospital,Newcastle upon Tyne,UK
| | - A Robson
- Department of Otolaryngology,North Cumbria University Hospitals,Carlisle,UK
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Torretta S, Rosazza C, Pace ME, Iofrida E, Marchisio P. Impact of adenotonsillectomy on pediatric quality of life: review of the literature. Ital J Pediatr 2017; 43:107. [PMID: 29178907 PMCID: PMC5702149 DOI: 10.1186/s13052-017-0424-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 11/13/2017] [Indexed: 12/11/2022] Open
Abstract
Adenotonsillectomy (ADT) is one of the most widely used procedures in the treatment of paediatric recurrent acute tonsillitis (RAT) and obstructive sleep apnoea syndrome (OSAS), both of which have significant repercussions on the patients' quality of life (QoL). The purpose of our review of literature was to highlight the great variety of tools that are currently used to evaluate QoL in children, to examine data available on their efficacy and the feasibility of their use in daily clinical practice, and to determine possible limitations related to an indirect and subjective assessment of QoL in children.Although the use of different parameters makes it difficult to compare the published studies, an analysis of the evidence currently available in the literature suggests that ADT has a generally positive impact on the QoL (especially in case of OSAS). It also highlights the importance of combining tonsillectomy and adenoidectomy in the treatment of OSAS, and documents the comparability of tonsillectomy and tonsillotomy in improving obstructive symptoms. In conclusion, our findings suggest that literature supports that ADT is associated with positive changes in QOL; however further studies using comparable standardised criteria are necessary to confirm the size and duration of this benefit.
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Affiliation(s)
- Sara Torretta
- Department of Clinical Sciences and Community Health, University of Milan; Otolaryngological Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20100, Milan, Italy.
| | - Chiara Rosazza
- Department of Pathophysiology and Transplantation, University of Milan; Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Elisabetta Pace
- Department of Pathophysiology and Transplantation, University of Milan; Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisabetta Iofrida
- Department of Clinical Sciences and Community Health, University of Milan; Otolaryngological Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20100, Milan, Italy
| | - Paola Marchisio
- Department of Pathophysiology and Transplantation, University of Milan; Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Kao SST, Peters MDJ, Dharmawardana N, Stew B, Ooi EH. Scoping review of pediatric tonsillectomy quality of life assessment instruments. Laryngoscope 2017; 127:2399-2406. [DOI: 10.1002/lary.26522] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 12/15/2016] [Accepted: 01/04/2017] [Indexed: 12/31/2022]
Affiliation(s)
| | - Micah D. J. Peters
- Joanna Briggs Institute; Faculty of Health Sciences, University of Adelaide
| | | | - Benjamin Stew
- ENT Head and Neck Surgery; Flinders Medical Centre and Flinders University
| | - Eng Hooi Ooi
- ENT Head and Neck Surgery; Flinders Medical Centre and Flinders University
- Department of Surgery; Flinders University; Bedford Park South Australia Australia
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Morad A, Sathe NA, Francis DO, McPheeters ML, Chinnadurai S. Tonsillectomy Versus Watchful Waiting for Recurrent Throat Infection: A Systematic Review. Pediatrics 2017; 139:peds.2016-3490. [PMID: 28096515 PMCID: PMC5260157 DOI: 10.1542/peds.2016-3490] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2016] [Indexed: 12/21/2022] Open
Abstract
CONTEXT The effectiveness of tonsillectomy or adenotonsillectomy ("tonsillectomy") for recurrent throat infection compared with watchful waiting is uncertain. OBJECTIVE To compare sleep, cognitive, behavioral, and health outcomes of tonsillectomy versus watchful waiting in children with recurrent throat infections. DATA SOURCES MEDLINE, Embase, and the Cochrane Library. STUDY SELECTION Two investigators independently screened studies against predetermined criteria. DATA EXTRACTION One investigator extracted data with review by a second. Investigators independently assessed risk of bias and strength of evidence (SOE) and confidence in the estimate of effects. RESULTS Seven studies including children with ≥3 infections in the previous 1 to 3 years addressed this question. In studies reporting baseline data, number of infections/sore throats decreased from baseline in both groups, with greater decreases in sore throat days, clinician contacts, diagnosed group A streptococcal infections, and school absences in tonsillectomized children in the short term (<12 months). Quality of life was not markedly different between groups at any time point. LIMITATIONS Few studies fully categorized infection/sore throat severity; attrition was high. CONCLUSIONS Throat infections, utilization, and school absences improved in the first postsurgical year in tonsillectomized children versus children not receiving surgery. Benefits did not persist over time; longer-term outcomes are limited. SOE is moderate for reduction in short-term throat infections and insufficient for longer-term reduction. SOE is low for no difference in longer-term streptococcal infection reduction. SOE is low for utilization and missed school reduction in the short term, low for no difference in longer-term missed school, and low for no differences in quality of life.
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Affiliation(s)
| | - Nila A. Sathe
- Health Policy, and Vanderbilt Evidence-based Practice Center, Institute for Medicine and Public Health, and
| | - David O. Francis
- Otolaryngology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Melissa L. McPheeters
- Health Policy, and Vanderbilt Evidence-based Practice Center, Institute for Medicine and Public Health, and
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Chinnadurai S, Jordan AK, Sathe NA, Fonnesbeck C, McPheeters ML, Francis DO. Tonsillectomy for Obstructive Sleep-Disordered Breathing: A Meta-analysis. Pediatrics 2017; 139:peds.2016-3491. [PMID: 28096514 PMCID: PMC5260158 DOI: 10.1542/peds.2016-3491] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2016] [Indexed: 01/08/2023] Open
Abstract
CONTEXT The effectiveness of tonsillectomy or adenotonsillectomy (hereafter, "tonsillectomy") for obstructive sleep-disordered breathing (OSDB) compared with watchful waiting with supportive care is poorly understood. OBJECTIVE To compare sleep, cognitive or behavioral, and health outcomes of tonsillectomy versus watchful waiting with supportive care in children with OSDB. DATA SOURCES Medline, Embase, and the Cochrane Library. STUDY SELECTION Two investigators independently screened studies against predetermined criteria. DATA EXTRACTION Two investigators independently extracted key data. Investigators independently assessed study risk of bias and the strength of the evidence of the body of literature. Investigators synthesized data qualitatively and meta-analyzed apnea-hypopnea index (AHI) scores. RESULTS We included 11 studies. Relative to watchful waiting, most studies reported better sleep-related outcomes in children who had a tonsillectomy. In 5 studies including children with polysomnography-confirmed OSDB, AHI scores improved more in children receiving tonsillectomy versus surgery. A meta-analysis of 3 studies showed a 4.8-point improvement in the AHI in children who underwent tonsillectomy compared with no surgery. Sleep-related quality of life and negative behaviors (eg, anxiety and emotional lability) also improved more among children who had a tonsillectomy. Changes in executive function were not significantly different. The length of follow-up in studies was generally <12 months. LIMITATIONS Few studies fully categorized populations in terms of severity of OSDB; outcome measures were heterogeneous; and the durability of outcomes beyond 12 months is not known. CONCLUSIONS Tonsillectomy can produce short-term improvement in sleep outcomes compared with no surgery in children with OSDB. Understanding of longer-term outcomes or effects in subpopulations is lacking.
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Affiliation(s)
| | | | - Nila A. Sathe
- Health Policy and the Vanderbilt Evidence-based Practice Center, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Melissa L. McPheeters
- Health Policy and the Vanderbilt Evidence-based Practice Center, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee
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