PT - JOURNAL ARTICLE AU - Chariton Papadakis AU - Konstantinos Chaidas AU - Theognosia Chimona AU - Maria Zisoglou AU - Alexandros Ladias AU - Efklidis Proimos AU - Michael Miligkos AU - Athanasios G. Kaditis TI - Assessing the Need for Adenotonsillectomy for Sleep-Disordered Breathing in a Community Setting.A Randomized Controlled Study AID - 10.1183/13993003.congress-2019.PA4980 DP - 2019 Sep 28 TA - European Respiratory Journal PG - PA4980 VI - 54 IP - suppl 63 4099 - http://erj.ersjournals.com/content/54/suppl_63/PA4980.short 4100 - http://erj.ersjournals.com/content/54/suppl_63/PA4980.full SO - Eur Respir J2019 Sep 28; 54 AB - 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 (4–10 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).