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Efficacy and safety of turbinate reduction surgery in children: a systematic review
1Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia. tjieraisient@gmail.com.
Insights
Turbinate reduction surgery effectively treats chronic nasal obstruction in children when medical options fail. This safe procedure shows low complication rates, improving nasal breathing quality of life.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Rhinology
Background:
- Inferior turbinate hypertrophy is a common cause of chronic nasal obstruction in children.
- This condition significantly impacts a child's quality of life.
- Medical treatments are often insufficient for severe cases.
Purpose of the Study:
- To evaluate the efficacy and safety of turbinate reduction surgery in pediatric patients.
- To assess outcomes for children with inferior turbinate hypertrophy refractory to medical management.
Main Methods:
- Systematic review of 23 articles including RCTs, single-arm trials, and cohort studies.
- Searched major databases (PubMed, Scopus, Cochrane, Web of Science) up to April 2023.
- Included studies on children under 18 undergoing any turbinate reduction technique, assessing objective and subjective outcomes.
Main Results:
- Most studies favored turbinate surgery, with objective measures showing significant improvement.
- Subjective measures indicated postoperative improvement in nearly all studies.
- Complication rates were low, with crusting (6.03%) being most common; the procedure is generally safe.
Conclusions:
- Turbinate reduction is an effective treatment for medically refractory nasal blockage due to inferior turbinate hypertrophy in children.
- The procedure demonstrates a favorable safety profile with minimal complications.
- Study design heterogeneity precluded a meta-analysis, highlighting a potential risk of bias.
Purpose:
Inferior turbinate hypertrophy is not a rare problem in children, it causes chronic nasal obstruction which can severely impact the quality of life. This study aimed to investigate the efficacy and safety of turbinate reduction surgery in children with impaired nasal breathing due to hypertrophied inferior turbinate that's refractory to medical treatment.
Methods:
We included 23 articles with various study designs: randomized controlled trials, single-arm clinical trials, and prospective and retrospective cohort studies. We searched PubMed, Scopus, Cochrane Library, and Web of Science with the relevant keywords till April 9th, 2023. The inclusion criteria were studied with the three prespecified study design that addressed children under 18 years who underwent turbinate reduction with any technique and evaluating the improvement whether by objective or subjective methods.
Results:
Studies used objective measures favor turbinate surgery except two that showed no significant difference between pre and postoperative results. All studies used subjective measures showed an improvement postoperatively except one study. Complication rates are rare, with crust formation is being the commonest (6.03%), however, the procedure is generally safe in children. In addition, follow-up periods varied widely between 2 weeks and more than 5 years.
Conclusion:
Turbinate reduction in children is an effective as a treatment method for nasal blockage due to inferior turbinate hypertrophy which is resistant to medical treatment. It is a safe procedure with low rates of complications, however, due to the heterogenicity of the study designs, with a possible risk of bias we could not conduct a meta-analysis besides our systematic review.
