Early Adenotonsillectomy Wins By a Nose

Is it beneficial for children to undergo an adenotonsillectomy, or is watching and waiting the better option? As it turns out, a few extra benefits put surgery in the win column.

As detailed in the New England Journal of Medicine, the study, “A Randomized Trial of Adenotonsillectomy for Childhood Sleep Apnea“, concludes that:

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 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.

Several news outlets, seized on the new study, essentially saying that the widely-performed surgical procedure “can reduce sleepiness and improve the quality of life, but putting off the surgery might not hurt either.”

In an article by Reuters reporter Gene Emery, Dr. Susan Redline of Boston-based Brigham and Women’s Hospital conceded that “Where you objectively measure these cognitive tasks, children can do fairly well in that motivated and structured environment” whether or not they have surgery.

Children with the surgery showed a large improvement on ratings of things such as impulsiveness, emotional control, and quality of sleep that were assessed by parents and teachers. “It really was across-the-board improvement in everyday life for surgery patients,” Redline said in the Reuters article. On the other hand, Redline added that “almost half the children improved spontaneously over the 7-month period without surgery.”

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