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Safeness, subjective and objective changes after turbinate surgery in pediatric patients: A systematic review
Christian Calvo-Henriquez1, Robson Capasso2, Gabriel Martínez-Capoccioni1
1Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Rhinology Study Group, Spain; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Spain.
Insights
Turbinate surgery in children is a safe procedure with low complication rates, showing improvement in nasal breathing. However, high-quality studies are lacking to recommend specific surgical techniques.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Rhinology
Background:
- Impaired nasal breathing is often linked to inferior turbinate issues.
- Surgical intervention for turbinate hypertrophy is common when medical treatments fail.
- The use of turbinate surgery in pediatric patients remains a subject of debate.
Purpose of the Study:
- To review the existing literature on the outcomes of turbinate surgery in children.
- To assess the safety and efficacy of turbinate surgery in pediatric populations.
Main Methods:
- A systematic search was conducted across multiple databases including PubMed, Cochrane Library, EMBASE, Scopus, Science Direct, SciELO, and Trip Database.
- Studies investigating individual outcomes of turbinate surgery in pediatric patients were included.
- Data extraction focused on objective and subjective assessments of outcomes and complication rates.
Main Results:
- Thirteen studies involving 1111 pediatric patients met the inclusion criteria.
- All studies reported improvements in nasal breathing following turbinate surgery.
- A low overall complication rate of 3.12% was reported, with minor bleeding being the most frequent adverse event.
Conclusions:
- Turbinate surgery in children is generally safe, with a low incidence of complications.
- Evidence suggests subjective improvements in nasal breathing after surgery.
- High-quality studies are needed to establish definitive recommendations for surgical techniques in pediatric patients.
Objective:
Inferior turbinates are the main structure related to impaired nasal breathing. When medical treatment fails, surgery is the next step, according to clinical guidelines. However, despite the widespread acceptance of this procedure, there is some controversy about performing it in children.
Data Sources:
Pubmed (Medline), the Cochrane Library, EMBASE, Scopus, Science direct, SciELO and Trip Database.
Review Methods:
We looked for articles in which the individual outcome of turbinate surgery in pediatric patients was investigated independently of whether it was the main objective of the study or not.
Results:
13 papers (1111 patients) met the inclusion criteria. 6 authors performed diverse objective assessment and 11 authors used subjective scales. All of them found improvement after surgery. Due to the heterogeneity of the methods used, they could not be included in a metanalysis. Eleven out of the 13 authors reported 3.12% complication rates, being minor bleeding the most common (1.30%), followed by crust (0.49%) and pain (0.47%).
Conclusions:
There is a lack of high quality studies in children. Turbinate surgery in children is a safe technique with low complication rates. The available evidence suggests improvement in subjective outcomes after turbinate surgery in children. We cannot make a formal recommendation of a surgical technique in children given the lack of high quality studies, and since comparison between available papers is not possible. Although the evidence at our disposal is weak, it suggests that the safest techniques are MAIT, radiofrequency, coblation and laser.
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