• Sherko Saeed Fathulla Zmnako Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Yusuf Ibrahim Chalabi Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Said Mustafa Said Hawler Medical University, Erbil, Kurdistan Region, Iraq.
  • Huner Mohamed Hama Ameen Sulaimani ENT- Head and Neck Surgery Teaching Center, Kurdistan Region, Iraq.
  • Rekawt Hama Rashid Krim Shorsh Teaching Hospital, Otolaryngology Center, Sulaimani, Kurdistan Region, Iraq.
  • Mohammed Subhan Mohammed Halabja General Hospital, Kurdistan Region, Iraq.



Adenoid, Tonsils, Quality of life



The tonsils and adenoid enlargement are the most common cause of respiratory tract obstruction in children and cause obstructive sleep apnea and snoring. These children may present with recurrent upper respiratory tract infection with frequent antibiotic uses. Parents may worry about some alteration in children’s behavior and development which are caused by adenotonsillar enlargement. 


To evaluate the quality of life of children with adenotonsillar enlargement, recurrent and chronic tonsillitis before and after adenotonsillectomy. 

Patients and Methods

A prospective observational study done. Data collected from (January 2015 to end of July, 2015). Parents of 118 children who underwent adenotonsillectomy in (ENT, Head and Neck Surgery – Sulaimani Teaching Center) were interviewed before the operation and 6 months after the operation, by using the questionnaire about quality of life, physical problems, sleeping problems, speech and swallowing problems, emotional discomfort, limitation of activities and parents’ concerns; each of them scored from zero to six.


The score obtained by the questionnaire after adenotonsillectomy significantlyreduced as compared to the score obtained before the operation. Symptoms which have the highest scores before the operation are nasal obstruction and snoring. There was a decrease in the number of upper respiratory tract infections after the adenotonsillectomy. There was a significant decrease in the use of antibiotics after adenotonsillectomy. 


We conclude that the quality of life of these children improved after adenotonsillectomy, especially the physical problems and sleep problems, the number of upper respiratory tract infections decreased and the decrease in the use of antibiotics, but children who have had symptoms of rhinitis had less improvement in their quality of life compared to the children who didn’t have these symptoms.


Di FrancescoI RC, Felipe SG, Komatsu CL. Improvement in the quality of life of children after adenotonsillectomy. Rev Bras Otorrinolaringol. 2004; 70:748-751.

Carneiro LE, Neto GC, Camera MG. Adenotonsillectomy Effect on the Life Quality of Children with Adenotonsillar Hyperplasia. Intl. Arch. Otorhinolaryngol. 2009; 13(3):270-276.

Pitkäranta A, Karma P. Tonsils and Adenoids. In: Graham JM, Scadding GK, Bull PD, Editors. Pediatric ENT. New York: Springer; 2007. p. 131-140.

Nikakhlagh S, Rahim F, Boostani H, Shirazi SB, Saki N. The Effect of Adenotonsillectomy on Quality of Life in Adults and Pediatric patients. Research Journal of Biological Sciences. 2006; 4 (12): 1259-1261. DOI:

Garetz SL. Behavior, cognition, and quality of life after adenotonsillectomy for pediatric sleep-disordered breathing: summary of the literature. Otolaryngol Head Neck Surg. 2008; 138:19-26. DOI:

Burton MJ, Glasziou PP. Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev. 2000; (2):CD001802. DOI:

Le TM, Rovers MM, van Staaij BK, van den Akker EH, Hoes AW, Schilder AG. Alterations of the oropharyngeal microbial flora after adenotonsillectomy in children: a randomized controlled trial. Arch Otolaryngol Head Neck Surg. 2007, 133:969-972. DOI:

Brodsky L, Poje C. Tonsillitis, Tonsillectomy and Adenoidectomy. In: Bailey BJ, Johnson JT, Newlands SD, Editors. Head & Neck Surgery-Otolaryngology. Fourth Edition. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 1948-1969.

Constantin E, Kermack A, Nixon GM, Tidmarsh L, Ducharme FM, Brouillette RT. Adenotonsillectomy improves sleep, breathing, and quality of life but not behavior. J Pediatr. 2007, 150:540-546 DOI:

Neelima Gupta, Lakshmi Vaid, PP Singh. Impact of Tonsillectomy on Quality-of-life inChildren: Our Experience. Indian Journal of Clinical Practice, Vol. 24, No. 6, November 2013, p:543-546

Beraldin BS, Rayes TR, Villela PH, Ranieri DM. Assessing the impact adenotonsilectomy has on the lives of children with hypertrophy of palatine and pharyngeal tonsils. Braz J Otorhinolaryngol . 2009;75(1):64-9. DOI:

Baumann I. Quality of life before and after septoplasty and rhinoplasty. GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery 2010; 9: 47-58.

The WHOQOL group. Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment. Psychol Med. 1998;28:551-558. DOI: 10.1017/S0033291798006667. DOI:

De Serres LM, Derkay C, Astley S, Deyo RA, Rosenfeld RM, Gates GA. Measuring quality of life in children with obstructive sleep disorders. Arch Otolaryngol Head Neck Surg. 2000; 126(12):1423-9. DOI:

Di FrancescoI RC, Felipe SG, Komatsu CL. Improvement in the quality of life of children after adenotonsillectomy. Rev Bras Otorrinolaringol. 2004; 70:748-751. DOI:

Verlade-Jurado E, Avila-Figueroa C. Methodological considerations for evaluating quality of life. SaludPublMéx. 2002;44(5):448-62.

Stewart MG, Friedman EM, De Jong A, Hulka GF, Bautista MH, Ander-son SE. Validation of an outcomes instrument for tonsil and adenoid disease. Arch Otolaryngol Head Neck Surg. 2001; 127(1):29-35. DOI:

Al-Kindy SA. Do antibiotics decrease post-tonsillectomy morbidity? Saudi Med J.2002; 23 (6): 705-7.

Ameen HH, Yaseen MA. The role of amoxicillin in preventing post-tonsillectomy complications. Zanco J.Med.Sci.2013; 17 (1). DOI:

Modrzynski M, Zawisza E. An Analysis of the incidence of adenoid hypertrophy in allergic children. Int. J. PediatrOtorhinolaringol. 2007; 71:713-719. DOI:

Mitchell RB, Kelly J, Call E, Yao N. Quality of life after adenotonsillectomy for obstructive sleep apnea in children. Arch Otolaryngol Head Neck Surg. 2004; 130:190-194. DOI:

Benninger M, Walner D. Obstructive sleep-disordered breathing in children. Clin Cornerstone. 2007; 9:6-12. DOI:

Conlon BJ, Donnelly MJ, Mcshane DP. Improvements in health and behavior following childhood tonsillectomy:a parental perspective at 1 year. Int J PediatrOtorhinolaringol. 1997; 41:155-161. DOI:

Fujimori I, Goto R, Kikushima K, Hisamatsu Ken-ichi, Murakami Y, Yamada T. Investigation of oral a –Streptococcus showing inhibitory activity against pathogens in children with tonsillitis. Int J PediatrOtorhinolaryngol. 1995; 33:249-255. DOI:



How to Cite

Zmnako S, Chalabi Y, Said S, Hama Ameen H, Krim R, Mohammed M. THE EFFECT OF ADENOTONSILLECTOMY ON THE QUALITY OF LIFE AMONG CHILDREN TWO TO THIRTEEN YEARS OF AGE. JSMC [Internet]. 2017 Aug. 15 [cited 2024 Jul. 22];7(2):185-94. Available from:

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