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.