Impact of tonsillectomy and adenoidectomy on child behavior

Arch Otolaryngol Head Neck Surg. 2000 Apr;126(4):494-8. doi: 10.1001/archotol.126.4.494.


Objective: To measure the impact of tonsillectomy and adenoidectomy (T&A) on children's behavioral and emotional problems using a standardized assessment.

Design: Prospective study.

Setting: Tertiary care children's hospital.

Patients: Thirty-six children, aged 2 through 18 years, with symptoms of nighttime 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 symptoms of sleep apnea and a standardized measure of children's competencies and problems, the Child Behavior Checklist for ages 2 through 3 years or 4 through 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 significant. In contrast, the mean total problem score was 7.5 points lower after surgery (95% confidence interval, 5.1-9.7), indicating a significant decrease (P<.001, matched t test).

Conclusions: This pilot study demonstrates a high prevalence (28%) of abnormal behavior in children undergoing T&A for chronic upper airway obstruction. Scores on a standardized measure of behavior improve following T&A, but larger studies with increased statistical power are needed to clarify the degree of improvement and its clinical importance.

MeSH terms

  • Adenoidectomy / psychology*
  • Child Behavior Disorders / diagnosis
  • Child Behavior Disorders / epidemiology*
  • Child Behavior Disorders / etiology
  • Child Behavior*
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Pilot Projects
  • Postoperative Period
  • Prevalence
  • Prospective Studies
  • Sleep Apnea Syndromes / complications
  • Sleep Apnea Syndromes / psychology
  • Sleep Apnea Syndromes / surgery*
  • Surveys and Questionnaires
  • Tonsillectomy / psychology*