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Turbinate Surgery in Children With Sleep-Disordered Breathing: A Randomized Prospective Study
Suhas Bharadwaj1, Turaj Vazifedan2, Cristina M Baldassari1,2
1Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School at Old Dominion University, Norfolk, Virginia, USA.
Objective:
To assess whether submucosal ablation of turbinates (SAT) at the time of adenotonsillectomy (AT) confers benefit in the reduction of nasal obstruction compared to AT alone.
Study Design:
A randomized, single-blinded study between 2014 and 2017. Children between 3 and 17 years with sleep-disordered breathing (SDB) and nasal obstruction were eligible. Patients had turbinate hypertrophy at baseline and were scheduled to undergo AT for SDB. The sinus and nasal quality of life survey (SN-5) and the visual analog scale (VAS) were measured.
Setting:
Tertiary Children's Hospital.
Methods:
Children were randomized to AT (control group) or AT with SAT. The study was powered to assess for changes in the SN-5 at 3 and 12 months.
Results:
In total, 51 patients were randomly assigned: 18 in the control group and 33 in the AT with SAT group. The SAT group had higher preoperative SN-5 scores compared to the control group. Both groups experienced improvement in SN-5 scores at 3 and 12 months. There was no statistically significant difference in the reduction of the total SN-5 score at 3 months (51% vs 50.1%, P = .707) and 12 months (52.1% vs 43.6%, P = .225) between the AT with SAT group and the AT alone group.
Conclusion:
Children with nasal obstruction that undergo AT and SAT experience improvement in SN-5 scores. It remains uncertain whether SAT performed at the time of AT confers additional improvement in nasal symptoms compared to AT alone. Future research should include an assessment of SDB symptom burden to allow for a definitive determination of the role of turbinate surgery in children with SDB.
