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