Quality of life following surgery for sleep disordered breathing: subtotal reduction adenotonsillectomy versus adenotonsillectomy in Australian children

Abstract

Adenotonsillectomy (AT) is indicated for children with obstructive sleep disordered breathing; however it has associated well-documented morbidity. A subtotal reduction AT has made a resurgence overseas, given a significantly reduced morbidity. This study hypothesized that full AT would provide a greater improvement in quality of life (QOL) when compared with a subtotal reduction AT (SRAT) in children with obstructive sleep disordered breathing. This cohort study used a single surgeon consecutive series of 181 children from the database of the senior author (ASC) following full AT (n= 118) or SRAT (n= 63). QOL was measured by the Glasgow Children's Benefit Inventory (GCBI), which was mailed to parents 3 months to 2 years post-operatively. Ninety-one of the 155 (59%) questionnaires were returned. There was an increase in QOL for children following AT (GCBI Total =+41.5) and SRAT (GCBI Total =+49.5). A significant increase in QOL was noted for all four domains of the GCBI. The GCBI total and four domains had no statistically significant difference in the improvement of scores by the two surgical groups. In this study, an SRAT provides identical post-operative QOL outcomes to full AT when performed for sleep disordered breathing in children. This adds to the evidence that in the absence of infective episodes, SRAT can be considered as a lower risk alternative to full AT.