Turbinate Surgery in Children With Sleep-Disordered Breathing: A Randomized Prospective Study

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Sleep Medicine

Background:

• Nasal obstruction is a common symptom in children with sleep-disordered breathing (SDB).
• Turbinate hypertrophy frequently contributes to nasal obstruction in this population.
• Adenotonsillectomy (AT) is a standard treatment for SDB, but its effect on nasal obstruction can be variable.

Purpose of the Study:

• To evaluate the efficacy of submucosal ablation of turbinates (SAT) when performed concurrently with AT for improving nasal obstruction in children.
• To compare the outcomes of AT with SAT versus AT alone in reducing nasal obstruction symptoms.

Main Methods:

• A randomized, single-blinded study involving 51 children (ages 3-17) with SDB and nasal obstruction.
• Participants underwent either AT alone (control) or AT with SAT.
• Outcomes were assessed using the Sinus and Nasal Quality of Life Survey (SN-5) and Visual Analog Scale (VAS) at 3 and 12 months post-operatively.

Main Results:

• Both groups showed improvement in SN-5 scores post-surgery.
• No statistically significant difference was observed in the reduction of total SN-5 scores between the AT with SAT group and the AT alone group at 3 months (51% vs 50.1%) and 12 months (52.1% vs 43.6%).
• The SAT group had higher preoperative SN-5 scores, indicating more severe baseline nasal symptoms.

Conclusions:

• While SAT combined with AT improves nasal symptoms in children, it does not appear to offer additional benefits over AT alone for nasal obstruction.
• Further research is needed to assess the impact on SDB symptom burden to clarify the role of turbinate surgery in pediatric SDB.