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Inferior turbinate surgery in children: a survey of practice patterns
Zi Yang Jiang1, Kevin D Pereira, Norman R Friedman
1Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Insights
Pediatric otolaryngologists frequently perform inferior turbinate surgery, primarily for nasal obstruction. Coblation is the preferred technique, with high physician satisfaction and generally minor complications, despite limited outcomes data.
Area of Science:
- Otolaryngology
- Pediatric Surgery
Background:
- Inferior turbinate reduction techniques vary in pediatric care.
- Practice patterns for this surgery have not been previously studied.
Purpose of the Study:
- To investigate the current practice patterns of inferior turbinate surgery among pediatric otolaryngologists.
Main Methods:
- A cross-sectional survey was distributed electronically to members of the American Society of Pediatric Otolaryngologists.
- 103 out of 249 (41%) questionnaires were completed and analyzed.
Main Results:
- 81% of respondents perform inferior turbinate surgery, most commonly for nasal obstruction (81%) and sleep-disordered breathing (16%).
- Coblation is the most frequent technique (51%), with 53% reporting a shift towards coblation or microdebridement.
- 71% of physicians reported satisfaction or high satisfaction; common complications included failure, epistaxis, and crusting, with 9% reporting major complications.
Conclusions:
- Inferior turbinate surgery is widely practiced by pediatric otolaryngologists, predominantly for nasal obstruction.
- Coblation is the leading surgical technique, associated with high physician satisfaction and predominantly minor complications.
- A need for more outcomes data exists, despite current high satisfaction rates.
Objectives/Hypothesis:
A variety of techniques for inferior turbinate reduction have been used in children, but to date practice patterns have not been studied. The purpose of this survey was to study the practice of inferior turbinate surgery among pediatric otolaryngologists.
Study Design:
Cross-sectional survey study.
Methods:
A questionnaire was sent electronically to American Society of Pediatric Otolaryngologists members.
Results:
A total of 249 questionnaires were sent, and 103 (41%) were completed. Six questionnaires were eliminated due to incompleteness. Seventy-nine (81%) respondents performed inferior turbinate surgery. The most common reason for not performing the procedure was lack of outcomes data. Coblation was the most common technique used in 51% of respondents. A change in surgical technique in the last 2 to 5 years, most commonly to coblation or microdebridement, was reported by 53% of respondents. Nasal obstruction was the primary indication for turbinate reduction (81%), followed by sleep-disordered breathing (16%). Respondents reported that 20% of turbinate reductions were sole procedures, and 80% were with other procedures: adenotonsillectomy, septoplasty, and sinus surgery. Fifty-six (71%) responders were either satisfied or very satisfied with the results of pediatric turbinate surgery. Failure of the procedure, epistaxis, and nasal crusting were commonly reported complications, and 9% reported major complications.
Conclusions:
A high proportion of pediatric otolaryngologists perform inferior turbinate surgery, most commonly for nasal obstruction. Coblation is the most common technique used, and complications are mostly minor. Physician satisfaction rates are high despite a paucity of outcomes data on the procedure.
