New research into common childhood surgery

Parents are being reminded to have realistic expectations post-surgery.

Parents of children who’ve had their adenoids and tonsils removed will tell you that the surgery can be life-changing.

It’s commonly picked up when children snore, breathe with their mouths open, an show aggressive and hyperactive behaviours during the day.

The recommended treatment is an adenotonsillectomy – the removal of adenoid and tonsils.

But new University of South Australia research suggests while the surgery can cure a child’s snoring it doesn’t change their behaviour.

That’s despite many parents and doctors believing it does.

The researchers looked at children’s behaviour at six months, two and four years after an adenotonsillectomy for clinically diagnosed sleep disordered breathing disorder (SDB).

The study was conducted in partnership with the University of Adelaide and the Women’s and Children’s Hospital.

Comparing them to a group of non-snoring children, the study showed improvements to children’s sleep and quality of life, but not their behaviour.

UniSA’s Professor Kurt Lushington said it shows the realistic expectations following surgery for parents.

“As most parents would attest, when a child has a bad night’s sleep, their behaviour reflects this the next day,” Prof Lushington said.

“But when their sleep quality is affected by snoring, parents often hope that by fixing this problem, they’ll also fix any associated behavioural issues. While I’d love to advise the opposite, this is not necessarily the case.

“Our research shows that a child’s quality of life improves following an adenotonsillectomy, which is clearly linked to a more solid, less interrupted sleep. But when it comes to behavioural difficulties, we did not see any significant changes.”

But interestingly, many parents still reported improved behaviour, probably in part due to their child finally getting a better night’s sleep.

“In clinical practice at a child’s post-operative review, many parents report major improvements in behaviour and attentiveness,” Prof Lushington explained.

“No doubt this is reassuring, but it’s probable that other factors are at play – most likely more sleep for the whole family and less worry from the parents, that together translate as a calmer, more attentive and emotionally responsive environment during the day.

“Beyond this, there is evidence to suggest that intervention much earlier in life may help. We may be leaving surgery too late.”

“Previous work conducted by UniSA found that an adenotonsillectomy at younger age of 3-5 years – may be important. Our previous work has suggested this too, so there is scope for further research.

“At this point, ensuring parents are fully aware of what an adenotonsillectomy can and can’t achieve for their child, is vital.”