摘要
Pediatric sleep-disordered breathing (SDB) and obstructive sleep apnea (OSA) are common conditions with proven associated neurocognitive and behavioral consequences. Adenotonsillectomy is one treatment option that can improve sleep parameters; however, its effects on neurocognition and behavior are inconsistent. This meta-analysis aimed to investigate the impact of surgery on neurocognition and behavior in children with SDB and OSA.
A systematic literature search was performed up to August 15, 2025, to assess the effects of surgery on pediatric SDB and OSA. Eight original studies were identified and systematically reviewed for the meta-analysis. Pooled estimates were calculated using random-effects models; subgroup analyses and meta-regression were performed where sufficient data were available. The pooled results indicated a moderate improvement in parent-reported behavioral measures (standardized mean difference [SMD] = −0.58, 95% CI −1.15 to −0.02) and a smaller, but significant improvement in executive function (SMD = −0.25, 95% CI −0.45 to −0.05). Objective neurocognitive and ADHD-related measures were not statistically significant, although effect estimates favored surgery.
Overall, adenotonsillectomy provides a reliable benefit in parent-reported behavioral symptoms and executive function in children with sleep-disordered breathing, while effects on objective neurocognitive and ADHD-related outcomes warrant further investigation.
•Adenotonsillectomy moderately improves parent-reported behavior (SMD = −0.58).•Executive function showed significant improvement after surgery (SMD = −0.25).•Objective neurocognitive and ADHD-related outcomes were generally non-significant.•Effect estimates for most outcomes favored surgery despite non-significance.•Early treatment of pediatric OSA may mitigate neurobehavioral impairments.