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Moideen SP, G M D, Sheriff RM, James F. Effectiveness of Adenoidectomy as a Standalone Procedure in Improving the Quality of Life of Children with Obstructive Sleep Apnea. Indian J Otolaryngol Head Neck Surg 2024; 76:2344-2350. [PMID: 38883488 PMCID: PMC11169206 DOI: 10.1007/s12070-024-04506-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/04/2024] [Indexed: 06/18/2024] Open
Abstract
Adenoid hypertrophy (AH) and its sequel like nasal obstruction, obstructive sleep apnoea (OSA), recurrent rhinitis and middle ear disorders are common diseases of pediatric age group, forming the major bulk of pediatric outpatient visits. The recommended approach to treating OSA in children is through adenotonsillectomy. Adenoidectomy is the surgical procedure of removal of hypertrophied adenoid tissues, which is the most common surgery performed by Ear, Nose, and Throat (ENT) surgeons. Given that adenoidectomy alone might lead to reduced instances of adverse outcomes, decreased risk of complications, and lower expenses, our objective was to explore the viability and suitability of adenoidectomy as a standalone treatment for pediatric OSA and to learn the significant effect of adenoidectomy on the quality of life (QOL) of children. Multicentric prospective study conducted in Department of ENT, Head and Neck Oncosurgery, Smita Memorial Hospital, Thodupuzha & Department of ENT, Head and Neck surgery, MCS Hospital, Muvattupuzha, Kerala, India from June 2022 to June 2023. Children between the age group of 5-10 years, who underwent adenoidectomy during the study period, satisfying the inclusion criteria were subjected for the study. Adenoidectomy was done for them using endoscope assisted coblation technique. Postoperative improvement in symptoms and change in quality of life were analyzed using obstructive sleep disorders-6 (OSD-6) questionnaire at the end of 3 months follow up. The surgeon observed a statistically significant improvement in all domains of OSD-6; and there by improvement in QOL in all patients, who underwent adenoidectomy in a course of three months. Adenoid hypertrophy is the most common cause of nasal obstruction in pediatric population and is creating a significant negative impact on the quality of life of children. Adenoidectomy is a safe and simple procedure which can provide significant improvement in quality of life of kids. Adenoidectomy in isolation could be a valid and recommended surgical choice for selected population of children displaying symptoms of pediatric OSA.
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Affiliation(s)
- Sanu P Moideen
- ACE - Centre for Advanced Care In ENT, Head and Neck Oncology, Muvattupuzha, 686 661 India
| | - Divya G M
- Department of Head and Neck Oncosurgery, Pariyaram Medical College, Kannur, Kerala India
| | - Razal M Sheriff
- ACE - Centre for Advanced Care In ENT, Head and Neck Oncology, Muvattupuzha, 686 661 India
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Carvalho ADMB, Lima MDDMD, Silva JMND, Neta NBD, Moura LDFADD. Bruxism and quality of life in schoolchildren aged 11 to 14. CIENCIA & SAUDE COLETIVA 2017; 20:3385-93. [PMID: 26602716 DOI: 10.1590/1413-812320152011.20772014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 05/24/2015] [Indexed: 11/21/2022] Open
Abstract
The purpose of this study is to assess quality of life in relation to oral health in schoolchildren with sleep bruxism. It is a transversal observational study of 594 schoolchildren (aged 11-14) of the municipality of Teresina, in the Brazilian State of Piauí. Quality of life was assessed through the Brazilian version of the CPQ11-14 questionnaire, in the short form (ISF:16).The presence of sleep bruxism was assessed from reports by the people legally responsible for the children. The results were analyzed by: calculation of an Odds Ratio (OR) estimate of chances; descriptive analysis; a Pearson Chi-squared test; a Likelihood Ratio test; and multiple logistic regression. A statistically significant association was found between sleep bruxism and the total score on the CPQ11-14 (p < 0.001), and with the scores in two domains: functional limitation (p = 0.033);and social wellbeing (p= 0.020).No association was found between quality of life and the variables gender or age. The final regression model showed that the presence of sleep bruxism increases the chance of having a greater effect on quality of life (ORadj=1.82 (1.54 - 2.10), IC = 95%).It is concluded that sleep bruxism had a negative impact on the quality of life of the schoolchildren, principally in the two domains functional limitations and changes in social wellbeing.
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Lima MS, Nader CMFF, Franco LP, Meira ZMA, Capanema FD, Guimarães RES, Becker HMG. Pulmonary hypertension evaluation by Doppler echocardiogram in children and adolescents with mouth breathing syndrome. Braz J Otorhinolaryngol 2017; 83:292-298. [PMID: 27388953 PMCID: PMC9444763 DOI: 10.1016/j.bjorl.2016.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 03/20/2016] [Accepted: 03/31/2016] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Adenotonsillar hyperplasia (ATH) and allergic rhinitis (AR) are the most common causes of upper airway obstruction in children. Such diseases, by affecting the upper airways, can cause chronic alveolar hypoventilation, pulmonary vasoconstriction and pulmonary hypertension, which in some cases, are irreversible. OBJECTIVE This cross-sectional study aimed to evaluate the prevalence of pulmonary hypertension in two groups of mouth-breathing (MB) 2-12 years old children with ATH and isolated allergic rhinitis, through Doppler echocardiography. METHODS 54 patients with ATH and indications for adenoidectomy and/or tonsillectomy and 24 patients with persistent allergic rhinitis were selected and submitted to Doppler echocardiography. The Systolic Pulmonary Artery Pressure (SPAP) was determined by tricuspid regurgitation and the Mean Pulmonary Artery Pressure (MPAP) was calculated from the SPAP. Similar measurements were carried out in 25 nasal breathing (NB) individuals. RESULTS The mean MPAP and SPAP were higher in the MB than in the NB group (17.62±2.06 [ATH] and 17.45±1.25 [AR] vs. 15.20±2.36 [NB] mmHg, p<0.005, and 25.61±3.38 [ATH] and 25.33±2.06 [AR] vs. 21.64±3.87 [NB] mmHg, p<0.005, respectively) and the mean acceleration time of pulmonary flow trace (Act) was higher in the NB than in the MB group (127.24±12.81 [RN] vs. 114.06±10.63ms [ATH] and 117.96±10.28 [AR] MS [AR]; p<0.0001). CONCLUSION None of the MB children (ATH and AR) met the PH criteria, although individuals with both ATH and isolated AR showed significant evidence of increased pulmonary artery pressure by Doppler echocardiography in relation to NB individuals. No differences were observed between the ATH and AR groups.
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Affiliation(s)
- Marcela Silva Lima
- Universidade Federal de Minas Gerais (UFMG), Departamento de Cirurgia e Oftalmologia, Belo Horizonte, MG, Brazil.
| | - Carolina Maria Fontes Ferreira Nader
- Faculdade de Saúde e Ecologia Humana (FASEH), Vespasiano, MG, Brazil; Faculdade de Saúde e Ecologia Humana (FASEH), Fundação de Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG), Programa Institucional de Bolsas de Iniciação Científica e Tecnológica (PROBIC), Vespasiano, MG, Brazil
| | - Letícia Paiva Franco
- Universidade Federal de Minas Gerais (HC-UFMG), Hospital das Clínicas, Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Belo Horizonte, MG, Brazil
| | - Zilda Maria Alves Meira
- Universidade Federal de Minas Gerais (UFMG), Departamento de Pediatria, Belo Horizonte, MG, Brazil
| | - Flavio Diniz Capanema
- Núcleo de Inovação Tecnológica, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Santa Efigênia, MG, Brazil
| | - Roberto Eustáquio Santos Guimarães
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Oftalmologia, Otorrinolaringologia e Fonoaudiologia, Belo Horizonte, MG, Brazil
| | - Helena Maria Gonçalves Becker
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Oftalmologia, Otorrinolaringologia e Fonoaudiologia, Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais (HC-UFMG), Hospital das Clínicas, Centro Multidisciplinar de Atenção ao Respirador Oral, Belo Horizonte, MG, Brazil
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Izuka EN, Feres MFN, Pignatari SSN. Immediate impact of rapid maxillary expansion on upper airway dimensions and on the quality of life of mouth breathers. Dental Press J Orthod 2016; 20:43-9. [PMID: 26154455 PMCID: PMC4520137 DOI: 10.1590/2176-9451.20.3.043-049.oar] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 10/02/2014] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE: To assess short-term tomographic changes in the upper airway dimensions and
quality of life of mouth breathers after rapid maxillary expansion (RME). METHODS: A total of 25 mouth breathers with maxillary atresia and a mean age of 10.5 years
old were assessed by means of cone-beam computed tomography (CBCT) and a
standardized quality of life questionnaire answered by patients' parents/legal
guardians before and immediately after rapid maxillary expansion. RESULTS: Rapid maxillary expansion resulted in similar and significant expansion in the
width of anterior (2.8 mm, p < 0.001) and posterior nasal floor (2.8 mm, p <
0.001). Although nasopharynx and nasal cavities airway volumes significantly
increased (+1646.1 mm3, p < 0.001),
oropharynx volume increase was not statistically significant (+1450.6 mm3, p = 0.066). The results of the quality of
life questionnaire indicated that soon after rapid maxillary expansion, patients'
respiratory symptoms significantly decreased in relation to their initial
respiratory conditions. CONCLUSIONS: It is suggested that RME produces significant dimensional increase in the nasal
cavity and nasopharynx. Additionally, it also positively impacts the quality of
life of mouth-breathing patients with maxillary atresia.
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Gomes ADM, Santos OMD, Pimentel K, Marambaia PP, Gomes LM, Pradella-Hallinan M, Lima MG. Quality of life in children with sleep-disordered breathing. Braz J Otorhinolaryngol 2013; 78:12-21. [PMID: 23108815 PMCID: PMC9450709 DOI: 10.5935/1808-8694.20120003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Accepted: 08/10/2012] [Indexed: 11/20/2022] Open
Abstract
Children may present sleep-disordered breathing (SDB) and suffer with adverse effects upon their quality of life. Objective This study assessed the quality of life of children with SDB, compared subjects with obstructive sleep apnea syndrome (OSAS) and primary snoring (PS), and identified which areas in the OSA-18 questionnaire are more affected. Methods This is a historical cohort cross-sectional study carried out on a consecutive sample of children with history of snoring and adenotonsillar hyperplasia. The subject's quality of life was assessed based on the answers their caregivers gave in the OSA-18 questionnaire and on diagnostic polysomnography tests. Results A number of 59 children participated in this study with mean age of 6.7 ± 2.26 years. The mean score of the OSA-18 was 77.9 ± 13.22 and the area most affected were “caregiver concerns” (21.8 ± 4.25), “sleep disturbance” (18.8 ± 5.19), “physical suffering” (17.3 ± 5.0). The impact was low in 6 children (10.2%), moderate in 33 (55.9%) and high in 20 (33.9%). PS was found in 44 children (74.6%), OSAS in 15 (25.6%). OSAS had higher score on “physical suffering” area than PS (p = 0.04). The AI (r = 0.22; p = 0.08) and AHI (r = 0.14; p = 0.26) were not correlated with OSA-18. Conclusion Sleep disordered breathing in childhood cause impairment in quality of life and areas most affected the OSA-18 were: “caregiver concerns”, “sleep disturbance” and “physical suffering”. OSAS has the domain “physical suffering” more affected than primary snorers.
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Soares AHR, Martins AJ, Lopes MDCB, Britto JAAD, Oliveira CQD, Moreira MCN. Qualidade de vida de crianças e adolescentes: uma revisão bibliográfica. CIENCIA & SAUDE COLETIVA 2011. [DOI: 10.1590/s1413-81232011000800019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O presente artigo tem como objetivo analisar as produções científicas nacionais, que abordam a temática da qualidade de vida ligada à saúde da criança e do adolescente. As bases de dados consultadas foram a SciELO e Bireme totalizando 30 artigos publicados no período de 1990 a 2008. Revelou-se uma predominância da abordagem quantitativa (70%) e um alto índice de aplicações de instrumentos de avaliações de qualidade de vida ligada à saúde (66,7%) e genéricos (28,6%). O conceito de qualidade de vida foi usado em duas vertentes: no contexto da pesquisa científica e como parte dos resultados desejados das práticas assistenciais e políticas públicas. O referido construto é apresentado através de uma perspectiva multidimensional, incluindo no mínimo as dimensões física, psicológica e social e de uma perspectiva subjetiva, o que implica no pressuposto de que a própria pessoa deve avaliar sua qualidade de vida. Observou-se ainda um movimento de valorização da perspectiva da criança e do adolescente como relator de sua experiência de vida. Conclui-se pela necessidade de criação e utilização de instrumentos de avaliação de qualidade de vida que valorizem a perspectiva de crianças e adolescentes e adequados a sua fase de desenvolvimento. A avaliação de qualidade de vida deve ser incorporada à avaliação clínica uma vez que a doença crônica repercute nas diversas dimensões da vida dos mesmos.
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Abstract
TEMA: sendo o sono necessário para termos energia, o ronco e a apneia do sono tornam-se obstáculos que acarretam problemas de saúde, como também problemas sociais, conjugais, escolares, entre outros. OBJETIVO: contribuir para um maior conhecimento do profissional fonoaudiólogo sobre as causas, consequências, diagnóstico e formas de tratamento da apneia obstrutiva do sono (AOS), a fim de favorecer a definição da conduta por este profissional, seja ela, encaminhar para um diagnóstico, tratar (por meio de fonoterapia) essa patologia ou indicar o tratamento médico, seja ele, cirúrgico ou conservador. CONCLUSÃO: as possíveis alterações fonoaudiológicas encontradas nestes pacientes são: língua alargada apresentando hipotonia, palato mole com volume aumentado, dificuldade na alimentação devido ao aporte insuficiente de ar e ao bruxismo, possivelmente causado pela tensão e ansiedade decorrentes das noites mal dormidas. Outras alterações podem ser encontradas decorrentes do tratamento cirúrgico empregado em alguns casos, como a disfagia ou até mesmo alterações na fala e na ressonância da fala decorrente de uma uvulopalatoplastia. O enfoque do tratamento fonoaudiológico é a mioterapia dos músculos envolvidos, priorizando a musculatura palatal. Percebe-se que o fonoaudiólogo pode contribuir para amenizar os sintomas encontrados nestas patologias, proporcionando uma qualidade de vida melhor aos seus portadores.
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Beraldin BS, Rayes TR, Villela PH, Ranieri DM. Assessing the impact adenotonsilectomy has on the lives of children with hypertrophy of palatine and pharyngeal tonsils. Braz J Otorhinolaryngol 2009; 75:64-9. [PMID: 19488562 PMCID: PMC9442261 DOI: 10.1016/s1808-8694(15)30833-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Accepted: 11/11/2007] [Indexed: 10/25/2022] Open
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Fernandes AA, Alcântara TA, D'Avila DV, D'Avila JS. Study of weight and height development in children after adenotonsillectomy. Braz J Otorhinolaryngol 2008; 74:391-4. [PMID: 18661013 PMCID: PMC9442106 DOI: 10.1016/s1808-8694(15)30573-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Accepted: 04/14/2007] [Indexed: 11/03/2022] Open
Abstract
The daily clinical observation of weight-height growth delays in children with obstructive hypertrophy of the pharyngeal and palatine tonsils is a workaday practice in pediatric otorhinolaryngology, and the surgical correction of this condition, when properly done in time, through adenotonsillectomy, can lead to a “catch up growth”. Aim To investigate the real weight-height gain present in this population when they are surgically treated. Materials and Methods Through a clinical prospective study, two groups of children carrying pharyngopalatine hypertrophy were followed up: group 1 was submitted to surgical intervention, and group 2 was not. All patients underwent standardization of anthropometrical measurements (weight and height), including their age-related percentiles, in the beginning and at the end of 06 (six) months. Results While group 1 increased its height average in relation to the initial average in 6.66cm, the control group increased its average in 1.9cm (p=0.0004). In relation to weight, group 1 increased 2150g in average, while group 2 presented an average increase of 690g (p=0.0010). Conclusions The children that underwent adenotonsillectomy acquired a higher weight-height growth potential in relation to those children who were not operated.
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de Lima Júnior JM, da Silva VC, de Freitas MR. Long term results in the life quality of children with obstructive sleep disorders submitted to adenoidectomy/adenotonsillectomy. Braz J Otorhinolaryngol 2008; 74:718-724. [PMID: 19082354 PMCID: PMC9445978 DOI: 10.1016/s1808-8694(15)31382-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2007] [Accepted: 08/25/2007] [Indexed: 11/23/2022] Open
Abstract
UNLABELLED Obstructive Sleep Disorders (OSD) affect mostly the pediatric population. Within this group, its main etiology is adenotonsillar hyperplasia, being adenoidectomy or adenotonsillectomy the best treatment option for quality of life improvement. AIM To asses quality of life of children with OSD after adenoidectomy/adenotonsillectomy. METHOD A prospective study was carried out with 48 children, between 2 and 11 years, with clinical manifestations of OSD and obstructive adenotonsillar hyperplasia. The OSA18 questionnaire was answered by the parents to evaluate their children's quality of life before surgery; at about thirty days and at least eleven months after the procedure. A higher score meant a worse quality of life. RESULTS Before surgery, the average OSA18 score was 82.83(SD=12.57), with an average global score for quality of life of 6.04(SD=1.66). Within thirty days after surgery, the average OSA18 score was 34.3 (SD=9.95) with an average global score of 9.6(SD=0.81), both showing significant reduction (p< 0.001). Thirty-four children (70.83%) were re-evaluated between 11 and 30 months (average=16.85; SD=5.16). The average OSA18 score was 35.44 (SD=19.95) with an average global score of 9.28 (SD=1.78). The postoperative evaluations weren't significantly different. CONCLUSION surgery improves the quality of life of children with OSD, and such improvement maintains for the long run.
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Affiliation(s)
- José Mário de Lima Júnior
- Medical doctor, otorhinolaryngology resident, Otorhinolaryngology Unit, Hospital Universitário Walter Cantídio HUWC./Universidade Federal do Ceará - UFC
| | | | - Marcos Rabelo de Freitas
- Doctoral degree, adjunct professor, Otorhinolaryngology Discipline, Faculdade de Medicina da UFC. Coordinator of the medical residency program in otorhinolaryngology, HUWC/UFC. Otorhinolaryngology Unit, Hospital Universitário Walter Cantídio. Department of Surgery. Universidade Federal do Ceará
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Silva VCD, Leite AJM. Quality of life in children with sleep-disordered breathing: evaluation by OSA-18. Braz J Otorhinolaryngol 2007; 72:747-56. [PMID: 17308827 DOI: 10.1016/s1808-8694(15)31041-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2006] [Accepted: 05/10/2006] [Indexed: 11/19/2022] Open
Abstract
UNLABELLED Sleep-disordered breathing (SDB) is prevalent. There is evidence of their effect on quality of life. AIM To assess the quality of life in children with SDB before and after adenoidectomy or adenotonsillectomy. METHODS A prospective before and after interventional study, with a component for assessment. A consecutive sample of children referred to adenoidectomy or adenotonsillectomy was recruited from the otolaryngology clinic; guardians answered a specific survey for the evaluation of quality of life in children with SDB, the OSA-18, before and at least 30 days after surgery. Nasofibroscopic and otolaryngological exams and a semi-structured survey on the childs social and clinical profile were done on both appointments. RESULTS 48 children with a mean age of 5.93 years (SD=2.43) were evaluated. The mean number of schooling years for guardians was 8.29 years (SD=3.14). The most frequent symptoms were: agitated sleep, apnea and snoring. The total mean score of the initial OSA-18 was 82.83 (major impact); following surgery, the total mean score was 34.15. The differences in the total scores and in the domains between the initial OSA-18 and post-surgery scores were all significant (p<0.00). CONCLUSION SDB has a relevant impact on quality of life, and patients show dramatic improvements after surgical treatment.
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Silva VCD, Leite AJM. Qualidade de vida em crianças com distúrbios obstrutivos do sono: avaliação pelo OSA-18. ACTA ACUST UNITED AC 2006. [DOI: 10.1590/s0034-72992006000600005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Distúrbios obstrutivos do sono (DOS) são prevalentes e existem evidências de afetarem a qualidade de vida das crianças. OBJETIVO: Avaliar a qualidade de vida de crianças com DOS antes e após adenoidectomia ou adenotonsilectomia. MATERIAL E MÉTODOS: Estudo prospectivo de intervenção, tipo antes e após, com componente avaliativo. Foi recrutada uma amostra consecutiva de crianças com indicação de adenoidectomia ou adenotonsilectomia em um ambulatório de otorrinolaringologia e aplicado aos cuidadores um questionário específico para a avaliação da qualidade de vida, o OSA-18, antes da cirurgia e com pelo menos 30 dias após. Foi realizado exame nasofibroscópico, otorrinolaringológico e questionário semi-estruturado sobre o perfil clínico e social da criança, em ambas as consultas. RESULTADOS: Foram avaliadas 48 crianças com média de idade de 5,93 anos (DP=2,43). A média de escolaridade do cuidador foi de 8,29 anos (DP=3,14). Os sintomas mais freqüentes foram: sono agitado, apnéia e ronco. A média de escore total do OSA-18 basal foi de 82,83 (grande impacto) e no pós-operatório, de 34,15. As diferenças nos escores total e dos domínios entre o OSA-18 basal e pós-operatório foram todas significantes (p<0,00). CONCLUSÃO: DOS apresentam impacto relevante na qualidade de vida e melhoram consideravelmente após o tratamento cirúrgico.
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