Impact of Adenotonsillectomy on Quality of Life in Pediatric Obstructive Sleep Apnoea (OSA): Insights from the OSA-18 Questionnaire

Abstract

Purpose: Hypertrophy of the adenoids and tonsils is a common cause of obstructive sleep apnoea (OSA) in children, with adenotonsillectomy as the primary treatment. This study aimed to assess the efficacy of surgical options (adenotonsillectomy, adenoidectomy, and tonsillectomy) in managing pediatric OSA and their impact on quality of life, using the OSA-18 questionnaire. Methods: This retrospective cohort study analyzed data from parents of 196 children who underwent adenoidectomy, tonsillectomy, or both. The OSA-18 questionnaire was administered online via Google Form to assess quality-of-life issues. Data collection occurred between November 4 and December 25, 2022. Statistical analysis included paired t-tests, ANOVA, Pearson’s correlation, and stepwise linear regression to evaluate pre-and post-surgery differences and associated factors. Results: A significant improvement in quality of life was observed following adenotonsillectomy, with a mean reduction of 15.14 points in OSA-18 scores. The greatest improvements were noted in the domains of physical symptoms and sleep disturbance, particularly among children with severe OSA. Most participants were male (63%), with an average pre-surgery weight of 25.5 kg. Prior to surgery, 34.18% used CPAP and 56.12% nasal steroids. Post-surgery, 83.16% were hospitalized for 1–2 days, with 4.08% requiring ICU care, and 26.53% experienced postoperative complications. Conclusion: Surgical interventions, particularly adenotonsillectomy, significantly improved quality of life in pediatric OSA patients, with marked benefits in severe cases.