Long-term Outcomes of Adenotonsillectomy vs. Non-Surgical Interventions for Sleep Apnea in Children

Study Objectives: Children with obstructive sleep apnea syndrome (OSAS) experience neuronal injury, which partly reverses after treatment. We hypothesized that adenotonsillectomy would yield greater improvements in memory and learning compared to non-surgical management over 9 months. Interventions involved polysomnography and randomized assignments to adenotonsillectomy or non-surgical management. Neurocognitive assessments at baseline, 7 weeks, and 9 months included various memory and learning subtests. Adenotonsillectomy-treated children showed enhanced memory and learning in Wide Assessment and Intelligence Scale trials, indicating improvements in neurocognitive functioning related to childhood OSAS. No notable differences were observed in Corsi-based tasks, visual intelligence, or Digit Span. Adolescents may exhibit different responses to neurocognitive deficits from OSAS. Our intent-to-treat analysis highlights the beneficial effects of adenotonsillectomy on long-term outcomes. Future research will explore the neurobiological factors affecting these improvements and the recovery of other cognitive skills.