Role of tonsillectomy and adenoidectomy in parental satisfaction of treatments for PANDAS.

Role of tonsillectomy and adenoidectomy in parental satisfaction of treatments for PANDAS. - 2021

CONCLUSION: Caregivers reported a decreasing frequency of symptoms over time regardless of treatment and had no difference in satisfaction. T&A was the most preferred treatment and the most impactful on symptoms for surgical patients. Given the challenges of immunologic therapies, T&A in combination with antibiotics should be considered as an early intervention for PANDAS. Copyright (c) 2021. Published by Elsevier Inc. METHODS: A list was created for PANDAS subjects seen at the Georgetown Pediatric Otolaryngology clinic from 2015 to 2018. Questionnaires were distributed to caregivers able to be contacted; 62% responded (n = 60). Subjects were placed in groups based on treatments reported: tonsillectomy and adenoidectomy (T&A, n = 28), T&A and intravenous immunoglobulin (IVIG, n = 22), or nonsurgical treatment(s) (n = 10). Caregivers reported frequencies for each of 10 associated symptoms from time of treatment to 12 months and also expressed their satisfaction with treatment. OBJECTIVE: To examine caregiver satisfaction with treatments for pediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS) and how symptom frequency changes over time. RESULTS: Patients were treated with antibiotics (n = 60, 100%), T&A (83.3%), IVIG (40%), Rituximab (15%), steroids (20%), and/or plasma exchange (10%). Caregivers for 66% (n = 33) of surgical patients identified T&A as the most effective treatment, and 80% would choose the operation again. No difference in median caregiver satisfaction level was found among the groups (n = 0.196). There was no significant difference in frequency for any of the symptoms (all p > 0.05) except choreiform movement (p = 0.0296).


English

0196-0709

10.1016/j.amjoto.2021.102963 [doi] S0196-0709(21)00064-8 [pii]


*Adenoidectomy
*Autoimmune Diseases/su [Surgery]
*Caregivers/px [Psychology]
*Parents/px [Psychology]
*Personal Satisfaction
*Streptococcal Infections/su [Surgery]
*Tonsillectomy
Adolescent
Adult
Anti-Bacterial Agents/tu [Therapeutic Use]
Autoimmune Diseases/co [Complications]
Child
Child, Preschool
Combined Modality Therapy
Humans
Immunoglobulins, Intravenous/tu [Therapeutic Use]
Middle Aged
Streptococcal Infections/co [Complications]
Time Factors


MedStar Washington Hospital Center


Psychiatry Residency


Journal Article

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