- Adenotonsillectomy was tied to improved measures of sleep and behavior but not cognition among preschoolers with symptomatic, predominantly mild obstructive sleep apnea (OSA).
Why this matters
- Commentary authors: the effect of the surgery on other, specific cognitive measures in this age group and potential long-term outcomes remain unclear.
- Improvement in global scores on the Woodcock Johnson III Brief Intellectual Ability scale was similar with and without adenotonsillectomy.
- Mean adjusted 12-month global scores did not differ between groups (465.46 vs 463.12; P=.29).
- However, other outcomes were better with vs without adenotonsillectomy (adjusted mean difference between groups):
- Polysomnogram arousals: –4.15/hour (P=.001);
- Apnea hypopnea index: –1.11 events/hour (P=.0001);
- Obstructive apnea hypopnea index: –0.98 events/hour (P<.0001>
- Proportion Pediatric Sleep Questionnaire “yes” responses: 2.89 (P=.07); and
- Behavior Assessment System for Children behavioral symptoms: –3.56 (P=.03).
- Australian multicenter randomized controlled trial among 190 children ages 3-5 years with symptomatic OSA (POSTA study).
- Randomization: early adenotonsillectomy (within 2 months) vs no adenotonsillectomy (12-month waitlist).
- Main outcome: global intelligence quotient scores at 12 months.
- Funding: National Health and Medical Research Council; Sydney University; others.
- Losses to follow-up.
- OSA was generally mild.