Pediatric Inferior Turbinate Hypertrophy: Diagnosis and Management. A YO-IFOS Consensus Statement

Area of Science:

• Otolaryngology
• Pediatric Respiratory Medicine
• Rhinology

Background:

• Pediatric inferior turbinate hypertrophy (PedTH) is a frequent, often overlooked cause of nasal breathing difficulties in children.
• Existing guidelines for PedTH diagnosis and management are lacking, leading to clinical controversies.
• A multidisciplinary approach is needed to address this condition effectively.

Purpose of the Study:

• To establish a clinical consensus statement (CCS) for the diagnosis and management of PedTH.
• To provide a multidisciplinary reference framework based on shared clinical experience and evidence.
• To address existing controversies and guide clinical practice in the absence of specific guidelines.

Main Methods:

• A panel of 20 international contributors developed the CCS using the modified Delphi method.
• A systematic literature review adhering to PRISMA criteria was conducted.
• Seven high-evidence articles were selected, and a 34-statement survey was used to reach consensus.

Main Results:

• Two items reached strong consensus, 17 reached consensus or near consensus, and 15 had no consensus after three voting rounds.
• The CCS provides a framework for managing PedTH, acknowledging its frequent association with other nasal or craniofacial disorders.
• Clinical examination and endoscopy are key diagnostic tools; rhinomanometry, cytology, and questionnaires have limited roles.

Conclusions:

• The CCS serves as a valuable reference for PedTH management until further prospective data become available.
• PedTH should be recognized as a distinct nasal obstructive disease in children, not merely an adult condition.
• Treatment should prioritize less invasive procedures, considering specific indications and features of available options.