@article {PapadakisPA4980, author = {Chariton Papadakis and Konstantinos Chaidas and Theognosia Chimona and Maria Zisoglou and Alexandros Ladias and Efklidis Proimos and Michael Miligkos and Athanasios G. Kaditis}, title = {Assessing the Need for Adenotonsillectomy for Sleep-Disordered Breathing in a Community Setting.A Randomized Controlled Study}, volume = {54}, number = {suppl 63}, elocation-id = {PA4980}, year = {2019}, doi = {10.1183/13993003.congress-2019.PA4980}, publisher = {European Respiratory Society}, abstract = {Aims: To assess whether children with sleep-disordered breathing (SDB) symptom severity above a certain level, measured by validated questionnaire, improve after adenotonsillectomy (AT) compared to no intervention.Methods: Children with snoring and tonsillar hypertrophy (4{\textendash}10 years old) who were candidates for AT were randomly assigned to 2 evaluation sequences (baseline and 3-month follow-up): (1) evaluation immediately before AT and at 3 months post-AT (AT group); or (2) evaluation at initial visit and at the end of the usual 3-month waiting period for surgery (control group). Outcomes were: (1) Pediatric Sleep Questionnaire sleep-related breathing disorder scale (PSQ-SRBD); (2) modified Epworth Sleepiness Scale (mESS); and (3) proportion of subjects achieving PSQ-SRBD \<0.33 (low-risk for apnea-hypopnea index >=5/h) if they had score >=0.33 at baseline.Results: 68 children were assigned to the AT and 72 to the control group and 2/3 of them had PSQ-SRBD>=0.33. The AT group showed greater improvement between follow-up and baseline than controls (between-group difference [95\% CI] for PSQ-SRBD: -0.31 [-0.35 to -0.27]; mESS: -2.76 [-3.63 to -1.90]; P\<.001 for both). Children with baseline PSQ-SRBD >=0.33 in the AT group had 8-times higher probability of achieving PSQ-SRBD \<0.33 at follow-up than controls with similar baseline score (risk ratio [95\% CI]: 8.33 [3.92 to 17.54]; P\<.001). Baseline nocturnal hypoxemia severity or obesity did not affect odds of symptom improvement.Conclusion: Among children with snoring, tonsillar hypertrophy and clinical indications for AT, those with preoperative PSQ-SRBD score >=0.33 show measurable clinical benefit post-AT.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA4980.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/54/suppl_63/PA4980}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }