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Pediatric inferior turbinate surgery: A review and meta-analysis of midterm nasal patency
Francisco Alves de Sousa1, Mariline Santos1, Maria Casanova1
1Serviço de Otorrinolaringologia e Cirurgia cérvico-facial (Otorhinolaryngology and Head & Neck surgery), Centro Hospitalar Universitário de Santo António, Largo do Prof. Abel Salazar, 4099-001, Porto, Portugal.
Insights
Pediatric inferior turbinate surgery significantly improves nasal patency in children with enlarged turbinates. Midterm outcomes are positive, regardless of the surgical technique used, including bone-sparing or bone-removal methods.
Area of Science:
- Otolaryngology
- Pediatric Surgery
Background:
- Enlarged inferior turbinates in children can cause nasal obstruction, but surgical treatment remains controversial due to limited evidence.
- Various surgical techniques exist for turbinoplasty, lacking consensus on optimal methods.
Approach:
- A systematic literature search and meta-analysis were conducted using PubMed and Cochrane databases.
- Included studies focused exclusively on pediatric patients with a minimum four-month follow-up, using objective measures for nasal obstruction.
Key Points:
- Seven studies were reviewed, with five included in the meta-analysis, totaling 510 pediatric patients.
- Midterm follow-up (4 months to 1 year) showed significant improvement in nasal patency post-surgery (p < 0.001).
- No significant difference in outcomes was observed between bone-sparing and bone-removal turbinate surgery techniques (p = 0.38).
Conclusions:
- This meta-analysis provides evidence for the positive midterm impact of inferior turbinate surgery on nasal patency in children.
- The findings suggest that turbinate surgery is effective regardless of the specific technique employed.
Objectives:
The surgical treatment of children with enlarged inferior turbinates is still controversial. Foundational evidence for indicating turbinoplasty is still scarce, and there is a myriad of proposed techniques. This work aimed to address the midterm nasal obstruction outcomes of pediatric inferior turbinate surgery.
Material And Methods:
A Literature search across PUBMED and Cochrane collaboration databases was undertaken, using the MeSH terms: turbinates, nasal obstruction, surgery, and children. Articles focusing on turbinate surgery with an exclusively pediatric cohort were included. The minimum follow-up time for inclusion was set at four months, and only the latest available follow-up in each study was considered. All the integrated studies used objective instruments to quantify nasal obstruction before and after surgery. A comprehensive review and meta-analysis were performed to assess nasal outcomes after the intervention. The 95% confidence interval of the effect magnitude for each study was calculated to elucidate effect sizes.
Results:
Seven studies met the inclusion criteria for review, and five were included in the meta-analysis, accounting for a total of 510 patients. The follow-up period ranged from 4 months to 1 year. Pooled results showed that nasal patency was significantly improved after surgery (p < 0.001) in the midterm follow-up. No significant differences were found between bone-sparing and bone-removal procedures (p = 0.38).
Conclusion:
This is the first meta-analysis to address midterm results of pediatric turbinate surgery. Our results suggest a positive impact of inferior turbinate surgery on nasal patency, irrespective of technique.
