{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:21:47Z","timestamp":1785763307881,"version":"3.56.0"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether the type and timing of intervention for pediatric sleep\u2010disordered breathing (SDB) affect the risk of developing neuropsychiatric and learning disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study using TriNetX, from January 2016 to March 2025, was conducted. Patients &lt;\u200918\u2009years with a diagnosis of SDB were included. Propensity score matching (1:1) based on demographics and concomitant diagnoses was performed for three comparisons: untreated versus surgical management (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009152,653), untreated versus non\u2010surgical management (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098,634), and surgical versus non\u2010surgical management (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098,873). The incidence of anxiety, depressive, eating, behavioral, and learning disorders at 1\u2009year, 5\u2009years, and anytime post\u2010intervention was recorded. In surgical patients, outcomes were also stratified by timing of surgery: within versus beyond 3, 6, and 12\u2009months of diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to surgery, no treatment was associated with significantly elevated risk of anxiety (risk ratio [RR] 1.44), depressive (RR 1.71), eating (RR 1.27), behavioral (RR 1.31), and learning disorders (RR 1.39) at 1\u2009year. Compared to surgery, non\u2010surgical management significantly increased the risk of anxiety (RR 2.27), depressive (RR 1.69), behavioral (RR 1.24), and learning disorders (RR 2.72) at 1\u2009year. Similar trends were observed at 5\u2009years. Surgery within 6\u2009months significantly reduced the risk of anxiety (RR 1.06), eating (RR 1.38), behavioral (RR 1.12), and learning disorders (RR 1.14) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 for all comparisons).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early surgical intervention for pediatric SDB is associated with significantly lower risks of neuropsychiatric and learning disorders compared to delayed surgery, non\u2010surgical management, or no treatment, necessitating validation through future prospective trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70205","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T12:09:12Z","timestamp":1760616552000},"page":"1928-1937","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Early Surgery Reduces Psychiatric and Learning Disorder Risk in Pediatric Sleep\u2010Disordered Breathing"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9001-5705","authenticated-orcid":false,"given":"Daniel J.","family":"Campbell","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Thomas Jefferson University Hospitals  Philadelphia Pennsylvania USA"},{"name":"Nemour's Childrens Health, Delaware Valley  Wilmington Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0504-7276","authenticated-orcid":false,"given":"W. Jack","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Thomas Jefferson University Hospitals  Philadelphia Pennsylvania USA"},{"name":"Nemour's Childrens Health, Delaware Valley  Wilmington Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-1510","authenticated-orcid":false,"given":"Leonard E.","family":"Estephan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Thomas Jefferson University Hospitals  Philadelphia Pennsylvania USA"},{"name":"Nemour's Childrens Health, Delaware Valley  Wilmington Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani","family":"Samarah","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Thomas Jefferson University Hospitals  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8473-8965","authenticated-orcid":false,"given":"Elliott","family":"Sina","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Thomas Jefferson University Hospitals  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3028-453X","authenticated-orcid":false,"given":"Nicole","family":"Aaronson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Thomas Jefferson University Hospitals  Philadelphia Pennsylvania USA"},{"name":"Nemour's Childrens Health, Delaware Valley  Wilmington Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Parkes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Thomas Jefferson University 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