Impact of tonsillectomy and adenoidectomy on child behavior

Objective: To measure the impact of tonsillectomy and adenoidectomy (T&A) o n children's behavioral and emotional problems using a standardized assessm ent. Design: Prospective study. Setting: Tertiary care children's hospital. Patients: Thirty-six children, aged 2 through 18 years, with symptoms of ni ghttime snoring, observed apneas, and daytime mouth breathing and physical examination results demonstrating 3+ or 4+ tonsils scheduled for T&A. Intervention: Parents completed a standard survey of their children's sympt oms of sleep apnea and a standardized measure of children's competencies an d problems, the Child Behavior Checklist for ages 2 through 3 years or 4 th rough 18 years, before T&A and 3 months postoperatively. Main Outcome Measure: The Child Behavior Checklist total problem score. Results: The preoperative Child Behavior Checklist total problem score was consistent with abnormal behavior for 10 children (28%). After T&A (n = 15) , only 2 scores were abnormal, but the change was not statistically signifi cant. In contrast, the mean total problem score was 7.5 points lower after surgery (95% confidence interval, 5.1-9.7), indicating a significant decrea se (P < .001, matched t test). Conclusions: This pilot study demonstrates a high prevalence (28%) of abnor mal behavior in children undergoing T&A for chronic upper airway obstructio n Scores on a standardized measure of behavior improve following T&A, but l arger studies with increased statistical power are needed to clarify the de gree of improvement and its clinical importance.