Adenotonsillectomy No Aid for Neurodevelopmental Outcomes in Children

However, improvements seen for behavior, symptoms, quality of life, and blood pressure with mild sleep-disordered breathing

By Lori Solomon HealthDay Reporter

FRIDAY, Dec. 8, 2023 (HealthDay News) — In children with mild sleep-disordered breathing (SDB), adenotonsillectomy does not significantly improve executive function or attention, according to a study published in the Dec. 5 issue of the Journal of the American Medical Association.

Susan Redline, M.D., from Brigham and Women’s Hospital in Boston, and colleagues compared early adenotonsillectomy versus watchful waiting and supportive care (watchful waiting) on neurodevelopmental, behavioral, health, and polysomnographic outcomes among children with mild SDB. The analysis included 459 children (aged 3 to 12.9 years) with snoring and an obstructive apnea-hypopnea index (AHI) <3 (394 with 12-month follow-up).

The researchers found that at 12 months, there were no statistically significant differences in change from baseline between the groups for executive function or attention, but behavioral problems, sleepiness, symptoms, and quality of life each improved more with adenotonsillectomy versus watchful waiting. There was an association between adenotonsillectomy and greater 12-month decline in systolic and diastolic blood pressure percentile levels (difference in changes, −9.02 and −6.52, respectively). Additionally, adenotonsillectomy was associated with less progression of the AHI to greater than three events/hour (1.3 percent of children in the adenotonsillectomy group versus 13.2 percent in the watchful waiting group; difference, −11.2 percent). Adenotonsillectomy was associated with a serious adverse event in six children (2.7 percent).

“These findings do not provide support for adenotonsillectomy in children with mild SDB with the goal of improving cognition, although it is possible that differences may have been observed with additional follow-up,” the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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