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Turbinate surgery in pediatric patients: A worldwide survey
Christian Calvo-Henriquez1, Manuel Tucciarone2, Jerome R Lechien3
1Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.
Insights
Pediatric turbinate surgery is increasingly common for nasal obstruction and sleep issues. However, there
Area of Science:
- Otolaryngology
- Pediatric Rhinology
- Sleep Medicine
Background:
- Impaired nasal breathing, often due to rhinitis, affects many children.
- Turbinate radiofrequency ablation (TRA) is a growing surgical option for pediatric turbinate hypertrophy.
Purpose of the Study:
- To assess current global clinical practices for turbinate surgery in pediatric patients.
Main Methods:
- A survey developed by 12 experts was translated into 7 languages.
- The survey was distributed to 25 global otolaryngologic societies, receiving 678 responses from 51 countries.
Main Results:
- 65% of respondents perform turbinate surgery in children, with higher rates among rhinology and pediatric otolaryngology specialists.
- Nasal obstruction (93.20%) and sleep-disordered breathing (53.28%) were primary indications.
Conclusions:
- Lack of scientific evidence contributes to a lack of consensus on indications and techniques for pediatric turbinate reduction.
- High agreement exists on pre-operative nasal steroid use, reintroducing steroids in allergic patients, and day-case surgery.
Objective:
Impaired nasal breathing is a common condition among pediatric patients, being rhinitis the most common cause. In recent years, turbinate surgery, mainly turbinate radiofrequency ablation (TRA), has increased in popularity amongst pediatric otolaryngologists and rhinologists as a safe and useful technique to address turbinate hypertrophy in pediatric patients. The present paper is designed with the aim of assessing the current worldwide clinical practice regarding turbinate surgery in pediatric patients.
Methods:
The questionnaire was developed based on previous researches, by a group of 12 experts from the rhinology and pediatric otolaryngology research group belonging to the Young Otolaryngologists of the International Federation of Otorhinolaryngological societies (YO-IFOS). The survey was then translated to 7 languages and sent to 25 scientific otolaryngologic societies around the globe.
Results:
15 scientific societies agreed to distribute the survey to their members. There were 678 responses from 51 countries. From them, 65% reported to usually perform turbinate surgery in pediatric patients. There was a statistically significant increased likelihood of performing turbinate surgery for those practicing rhinology, sleep medicine, and/or pediatric otolaryngology compared to other subspecialties. The main indication to perform turbinate surgery was nasal obstruction (93.20%); followed by sleep disordered breathing (53.28%), chronic rhinosinusitis (28.70%) and facial growth alterations (22.30%).
Conclusions:
There is no general consensus on the indications and ideal technique for turbinate reduction in children. This dissension arises mainly from the lack of scientific evidence. The points with highest agreement (>75%) between respondents is the use of nasal steroids prior to surgery; reintroducing nasal steroids in allergic patients; and performing turbinate surgery as day-case surgery.
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