الفهرس 
Introduction and Aim of the workOnly 14 pages are availabe for public view
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Abstract
Obstructive sleep apnea (OSA) in children is a disorder characterized by repeated and/or prolonged airway obstructions during sleep, in the form of apneas and hypopneas throughout the night (American Academy of Pediatrics, 2002).
Obstructive sleep apnea syndrome (OSAS) exhibit specific cognitive dysfunctions that include deficits in memory, problem solving and behavioural functioning (Wang, et al,.2010). This is problematic, as SDB with AHI < 1 can still impact children’s academic performance and behavior (Rosen et al., 2004).
The main risk factors include adenotonsillar hypertrophy, obesity, race, craniofacial deformity and neuromuscular diseases (Marcus et al., 2012) .
Adenotonsillar hypertrophy is the most common cause of OSAS in otherwise healthy children. However, the report that young children who snore frequently and loudly during sleep are at greater risk for poor academic performance in later years, even well after snoring has resolved, suggests that the neurocognitive deficits may be only partially reversible after treatment. Adenotonsillectomy results in significant improvement in clinical as well as polysomnographic parameters. Improvement in learning and behavior has been reported following treatment of OSAS in children (Friedman et al., 2003).
The purpose of the present study was to evaluate the effect of adenotonsillectomy (AT) on the cognition and scholastic achievement of children with Obstructive Sleep Apnea (OSA) in order to put a plan for proper management of those children. This group included 50 children were diagnosed as OSA due to adenotonsillar hypertrophy confirmed by polysomnography. Those 50 children were selected from 150 children suspected with OSA who came to our unit complaining from symptoms of obstructive sleep apnea (OSA) and seeking for adenotonsillectomy. They were 24 males ( 48 %) and 26 females ( 52%), with a mean age of 101.5±15.6 and a range of (72-120) months. All fifty children underwent a battery of neurocognitive tests containing process-oriented intelligence scales (Stanford Binet Intelligance scale and Illinois Test of psycholingustic ability) in order to show the effect of adenotonsillectomy (AT) on scholastic achievement of children with Obstructive Sleep Apnea (OSA).
The results obtained from this study showed that:
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the auditory perceptual assessment (APA) .
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the tympanogram.
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the symptoms of OSA .
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the IQ.
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the mental age.
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the PLA of AR (auditory reception).
• A statistical significant differences were obtained between preoperative and postoperative examination of the study group as regard the PLA of VR (visual reception).
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the PLA of ASM (auditory sequential memory).
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the PLA of VSM (Visual sequential memory).
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the PLA of AA (Auditory association).
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the PLA of VA (Visual association).
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the PLA of AC (Auditory closure).
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the PLA of VC (Visual closure).
• A statistical significant differences were obtained between preoperative and postoperative examination of the study group as regard the PLA of ME (Mental Expression).
• A statistical significant differences were obtained between preoperative and postoperative examination of the study group as regard the PLA of VE (Visual Expression).
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the PLA of GC (Grammatic closure).
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the PLA of SB (Sound Blending).
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the Total PLA .
• A statistical highly significant differences were obtained between preoperative and postoperative examination of the study group as regard the Total row score of Illinois test.
• A statistical significant differences were obtained between preoperative and postoperative examination of the study group as regard Academic performance.
• A high negative significant correlation were obtained between AHI and O2 saturation of the study group.(p<0.001)
• A high negative significant correlation were obtained between AHI and IQ . (p<0.001)
• A high negative significant correlation were obtained between AHI and Academic performance. (p<0.001)
• A negative non significant correlation were obtained between AHI, mental age and total PLA.