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儿童下鼻甲手术:中期鼻腔通畅性的回顾性分析和荟萃分析。

Pediatric inferior turbinate surgery: A review and meta-analysis of midterm nasal patency.

机构信息

Serviço 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.

出版信息

Int J Pediatr Otorhinolaryngol. 2023 Sep;172:111661. doi: 10.1016/j.ijporl.2023.111661. Epub 2023 Jul 19.

Abstract

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.

摘要

目的

儿童下鼻甲肥大的手术治疗仍存在争议。下鼻甲成形术的基本证据仍然缺乏,并且有许多建议的技术。本研究旨在探讨儿童下鼻甲手术的中期鼻塞结局。

材料和方法

通过 PUBMED 和 Cochrane 合作数据库进行文献检索,使用 MeSH 术语:鼻甲、鼻塞、手术和儿童。纳入专门针对鼻甲手术且仅包含儿科队列的文章。纳入的最小随访时间为 4 个月,并且仅考虑每个研究中最新的可用随访数据。所有综合研究均使用客观仪器在手术前后量化鼻塞。对纳入的研究进行全面综述和荟萃分析,以评估干预后的鼻腔结局。计算每个研究的效应大小的 95%置信区间以阐明效应量。

结果

有 7 项研究符合综述纳入标准,其中 5 项研究纳入荟萃分析,共纳入 510 例患者。随访时间从 4 个月到 1 年不等。汇总结果表明,中期随访时手术可显著改善鼻腔通畅度(p<0.001)。骨保留和骨切除手术之间未见显著差异(p=0.38)。

结论

这是第一项针对儿童鼻甲手术中期结果的荟萃分析。我们的结果表明,下鼻甲手术对鼻腔通畅度有积极影响,与技术无关。

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