TY - BOOK AU - Powell, Daniel TI - Role of tonsillectomy and adenoidectomy in parental satisfaction of treatments for PANDAS SN - 0196-0709 PY - 2021/// KW - *Adenoidectomy KW - *Autoimmune Diseases/su [Surgery] KW - *Caregivers/px [Psychology] KW - *Parents/px [Psychology] KW - *Personal Satisfaction KW - *Streptococcal Infections/su [Surgery] KW - *Tonsillectomy KW - Adolescent KW - Adult KW - Anti-Bacterial Agents/tu [Therapeutic Use] KW - Autoimmune Diseases/co [Complications] KW - Child KW - Child, Preschool KW - Combined Modality Therapy KW - Humans KW - Immunoglobulins, Intravenous/tu [Therapeutic Use] KW - Middle Aged KW - Streptococcal Infections/co [Complications] KW - Time Factors KW - MedStar Washington Hospital Center KW - Psychiatry Residency KW - Journal Article N2 - 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) UR - https://dx.doi.org/10.1016/j.amjoto.2021.102963 ER -