Carole L. Marcus, M.B., B.Ch., from the Children's Hospital of Philadelphia, and colleagues randomized 464 children (aged 5 to 9 years) with obstructive sleep apnea syndrome to either early adenotonsillectomy or watchful waiting. At baseline and after seven months, polysomnographic, cognitive, behavioral, and health outcomes were assessed.
The researchers found that the change in attention and executive function score on the Developmental Neuropsychological Assessment did not significantly differ between study groups (mean improvement, 7.1 in the early-adenotonsillectomy group and 5.1 in the watchful-waiting group). In the behavioral, quality-of-life, and polysomnographic findings, there were significant reductions in symptoms in the early-adenotonsillectomy group. A larger proportion of children in the intervention group had normalization of polysomnographic findings than did in the watchful waiting group (79 versus 46 percent).
"As compared with a strategy of watchful waiting, surgical treatment for the obstructive sleep apnea syndrome in school-age children did not significantly improve attention or executive function as measured by means of neuropsychological testing but did reduce symptoms and improve secondary outcomes of behavior, quality of life, and polysomnographic findings, thus providing evidence of beneficial effects of early adenotonsillectomy," the authors write.
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