Effect of adenotonsillectomy on the symptoms of attention deficit hyperactivity disorder in children with adenotonsillar hypertrophy

Chronic hypertrophy of tonsils and adenoids is the most prevalent cause of sleep apnea in children, leading to multiple behavioral disorders. Attention deficit hyperactivity disorder (ADHD) is a heterogeneous disorder caused by adverse biological, social and psychological conditions. This study aimed to evaluate the effect of adenotonsillectomy on ADHD symptoms in children with adenotonsillar hypertrophy before and six months after the surgery.

This descriptive-analytical study was performed on 37 children with adenoid hypertrophy in Gorgan, north of Iran during 2018. The data gathering tool was a two-part questionnaire; the first part contained personal data (age, gender), and the second part included the strengths and difficulties checklist. Patients were placed in three groups of hyperactivity, inattention and impulsivity based on 18 criteria of Diagnostic and Statistical manual of Mental disorders. The questionnaires were completed directly by the project performers. Information was collected from the parents. The strengths and difficulties questionnaire (SDQ) was used to assess children before and six months after the adenotonsillectomy surgery.

The average and standard deviation of scores in subscales of emotional symptoms, conduct problems, hyperactivity-inattention, peer relationship problems and prosocial behavior were improved, also a significant difference was observed between SDQ scores before and after adenotonsillectomy (P<0.05).

Adenotonsillectomy can significantly reduce the SDQ score. Therefore, in children with hyperactivity, a medical disorder such as adenoid hypertrophy can cause the onset, exacerbation and persistence of the disease. Proper treatment can be a major factor in controlling the severity of symptoms and even in improving the patient’s recovery.