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Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Pediatric septoplasy: a review of the literature
1rachael.lawrence@hotmail.co.uk
Insights
Pediatric septoplasty is safe and does not impede nasal and facial growth in children. Delaying surgery when indicated may lead to worse outcomes, suggesting earlier intervention may be beneficial.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Craniofacial Development
Background:
- Historical concerns regarding pediatric septoplasty's impact on facial growth.
- Emerging evidence suggests safety in appropriately selected pediatric patients.
Purpose of the Study:
- To determine the effect of pediatric septoplasty on nasal and facial growth.
- To review clinical indications and optimal surgical timing.
Main Methods:
- Structured literature review of PubMed, Ovid Medline, and Cochrane databases.
- Keywords included pediatric, childhood, septoplasty, nasal septum, indications, nasal growth, and facial growth.
Main Results:
- Three studies found pediatric septoplasty does not interfere with nasal or facial development.
- External septoplasty may impact nasal dorsum growth; uncorrected deviated septa correlate with facial/dental anomalies.
Conclusions:
- Pediatric septoplasty generally does not affect facial growth.
- Delaying indicated surgery can worsen deformity and asymmetry.
- Further research is needed on early surgical correction, potentially from birth.
Objectives:
Controversy has surrounded the procedure of pediatric septoplasty since the 1950s due to concerns over an adverse effect on nasal and facial growth. However, more recent evidence has demonstrated that septoplasty can be safely performed without affecting nasal and facial development in the appropriately selected pediatric patient. The purpose of this article is to establish the impact of pediatric septoplasty on nasal and facial growth and review the clinical indications and evidence for timing of surgery according to the most recent literature.
Methods:
A structured review of the PubMed, Ovid Medline and Cochrane Collaboration databases (Cochrane Central Register of Controlled Trials, Cochrane Database of Systemic Reviews) was undertaken, using the terms: pediatric, childhood, septoplasty, nasal septum, indications, nasal growth and facial growth.
Results:
Three long term follow up studies using anthropometric measurements were identified which concluded that pediatric septoplasty does not interfere with normal nasal or facial development. A further similar study concluded that external septoplasty does not affect most aspects of nasal and facial growth, but may negatively influence growth of the nasal dorsum. Furthermore, one study demonstrated that a group of children with symptomatic uncorrected deviated nasal septum had a statistically significant increased occurrence of facial and dental anomalies compared with age and sex matched controls, therefore supporting a role for septoplasty.
Conclusions:
Evidence exists to support that pediatric septoplasty can be performed without affecting most aspects of nasal and facial growth. Furthermore, not performing or delaying septoplasty when indicated may adversely affect nasal and facial growth with compounding adverse effects in terms of deformity and asymmetry. Despite the majority advocating the timing of septal surgery to be 6 years and older, more clinical studies are required that may provide further evidence for correction of septal deviations in younger children, perhaps even at birth.
