Physical and emotional disturbances in children with adenotonsillar hypertrophy.

OBJECTIVE: Enlarged tonsils and adenoids (part of Waldeyer's ring) are responsible for obstructive sleep disordered breathing. Obstructive sleep disordered breathing episodes lead to hypoxaemia, hypercapnia and a state of arousal, all of which affect normal development of the nervous system. In this study, two hypotheses were tested: (1) obstructive sleep disordered breathing is caused by adenotonsillar hypertrophy and is associated with hypoxia and brain dysfunction; and (2) children with obstructive sleep disordered breathing more commonly display emotional lability, depressive behaviour and anxiety. MATERIAL AND METHODS: A total of 225 children were examined. The study group consisted of 121 children with adenotonsillar hypertrophy (87 aged six to nine years and 34 aged 10 to 13 years) and with obstructive sleep apnoeas and hypopnoeas confirmed by polysomnography. Patients were compared with 104 children with no obstructive sleep disordered breathing and no adenotonsillar hypertrophy (74 aged six to nine years and 30 aged 10 to 13 years). The following tests were used to measure the children's emotional disorders: the children's depression inventory; the state-trait anxiety inventory for children; and the emotional instability scale. The average values and standard deviations were calculated for all results. Student's t-test was used to compare differences in all groups of children. The minimum level of p < 0.05 was set as statistically significant. RESULTS: Children with adenotonsillar hypertrophy are more likely to experience poor brain development and sleep problems. They also have emotional disturbances. In the sick and healthy children aged six to nine years, mean results for the emotional instability scale were statistically significantly different in the two groups, being higher in children with adenotonsillar hypertrophy than in healthy children. Mean values for the children's depression inventory test were higher in children with adenotonsillar hypertrophy, but the differences were not statistically significant. In the state-trait anxiety inventory for children test, the mean T score was T = 1.760 and the level of significance was p = 0.08 for both groups. Since the standard level of significance was p < 0.05, the differences in mean values for the state-trait anxiety inventory for children test bordered on statistical significance. There were no differences between tests results in the older children (10 to 13 years). CONCLUSIONS: Recent studies have confirmed the negative emotional effect of adenotonsillar hypertrophy induced obstructive sleep disordered breathing in children aged six to nine years. The main problems are emotional lability, and anxiety and depressive disturbances. Such emotional problems subside in older children (aged 10 to 13 years).

[The evaluation of certain psychological indices concerning cognitive and emotional behaviors in patients after radical neck dissection]. / Ocena niektórych psychologicznych wskazników zachowan poznawczo-emocjonalnych u chorych po radykalnym usunieciu wezlów chlonnych szyi.

Every disease and especially neoplasmatic disease is a source of deep mental experiences. The aim of this study was the establishment of some psychological behavioural parameters in 55 patients who underwent radical neck dissection and in 32 patients operated for other, non-neoplasmatic laryngologic diseases. In order to evaluate psychological state of the patients the following of States and Personality Traits (TISCO), 2. Feeling of Safety Question Sheet (KPB), 3. Profile of Mood States (POMS), 4. Scale of Hopelessness (HS-8). It was stated, that patients after radical neck dissection have deviations concerning indexes of cognitive and emotional behaviour and that there are differences between patients operated as the reason of neoplastic processes and other patients. These differences appear also among persons examined in the period shorter than 1 year from their surgery as opposed to patients operated earlier than 1 year before examinations. The fact of laryngectomy did not appear to have significant influence upon most of the evaluated indexes of cognitive and emotional behaviours.

[Subjective evaluation of adaptation to life in patients after radical neck dissection]. / Subiektywna ocena przystosowania do zycia u chorych po radykalnym usunieciu wezlów chlonnych szyi.

Neoplastic disease is the reason for limitation in life activity and functioning. The aim of study was assessment of adaptation to life after radical neck dissection. 87 subjects were followed up: 55 patients (group A) after radical neck dissection and 32 operated on for non-neoplastic ORL diseases. Patients from group A almost in all estimated indices showed statistical significant differences in comparison with group B. Only some differences were noted between patients examined in the period shorter and longer than one year after operation. There were no differences between patients after total laryngectomy and these who were cured in other procedures.