The POSTA study: 24-month follow-up of IQ after randomised adenotonsillectomy for mild OSA in preschoolers

Abstract

Introduction: The POSTA study is a multicentre, randomised controlled trial to evaluate whether preschool children with symptoms of OSA would show changes in neurocognitive function that were affected by the timing of their adenotonsillectomy. Methods: 190 children (age 3-5 yrs) were randomly assigned to early AT (within 2 months) or to routine wait lists (12-months' wait, NoAT). Baseline and 12-month assessments included cognitive and behavioral testing, medical assessment, polysomnography (PSG), and audiology. The primary outcome was global IQ, measured by the WJIII Brief Intellectual Ability (BIA). Questionnaires included the Pediatric Sleep Questionnaire (PSQ), Parent Rating Scale of the Behavioral Assessment System for Children-II (PRS-BASC) and Behavior Rating of Executive Functioning (BRIEF-P)). Results: Recruitment and follow-up are now completed. A subgroup of 107 children, or 56% of those studied at baseline, attended follow-up testing at 24 months after randomization. This included 55 assigned to early AT (90% of those seen at 12-month review) and 52 assigned to routine surgery (86.7% of those seen at 12-month follow-up). Those having routine surgery had adenotonsillectomy following their first, 12-month review and 12-months before this follow-up. Results will be analysed in an equivalent manner to the first review at 12-months, to evaluate using linear regression in which WJIII outcomes at 24-month follow-up are the dependent variable and treatment allocation the main effect, with baseline scores as the covariate. Conclusion: This study will provide long term follow-up of a group of preschool children who were randomly assigned to the timing of adenotonsillectomy in order to evaluate whether the cognitive functions which are thought to be affected by OSA, show changes over time depending on the timing when adenotonsillectomy is undertaken, as well as following changes in sleep, symptoms, and polysomnographic findings over time.L6342517662021-03-02 <br />