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Looking for a cutoff value for the decongestant test in children suffering with turbinate hypertrophy

Christian Calvo-Henriquez1,2, Miguel Mayo-Yáñez3,4, Jerome R Lechien3,5

  • 1Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Rhinology Study Group, Paris, France. christian.ezequiel.calvo.henriquez@sergas.es.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|February 10, 2021
PubMed

Insights

A new study establishes a cutoff value for the nasal decongestant test using rhinomanometry to help select pediatric patients for turbinate surgery, improving diagnosis for chronic nasal obstruction.

Area of Science:

  • Otolaryngology
  • Pediatric Rhinology

Background:

  • Chronic nasal obstruction in children is often caused by adenoid and turbinate hypertrophy.
  • Current guidelines lack specific indications for pediatric turbinate surgery.
  • The nasal decongestant test simulates turbinate surgery effects to aid in diagnosis.

Purpose of the Study:

  • To establish a cutoff value for the nasal decongestant test with rhinomanometry.
  • To identify children who would benefit from turbinate surgery.

Main Methods:

  • The study included 72 children with turbinate hypertrophy and 24 healthy controls, aged 4-15 years.
  • Anterior active rhinomanometry was performed with and without a nasal decongestant.
  • Cases underwent turbinate radiofrequency ablation, with or without adenoidectomy.

Main Results:

  • A statistically significant difference in decongestant improvement was observed between cases (57.91%) and controls (15.67%).
  • The ROC curve showed an area under the curve of 0.97.
  • A 38.88% improvement in nasal resistance with decongestant yielded the highest specificity and Youden's index.

Conclusions:

  • A preliminary cutoff value for the pediatric nasal decongestant test has been established.
  • This test can assist in selecting children for turbinate surgery.
  • Further research may refine indications for pediatric turbinate surgery.
Abstract

Keywords:
AdenoidsMAITRadiofrequencyRhinitisRhinomanometryTurbinates

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