Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia.
Eur Arch Otorhinolaryngol. 2024 Apr;281(4):1629-1641. doi: 10.1007/s00405-023-08327-9. Epub 2023 Nov 9.
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.
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.
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.
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.
下鼻甲肥大在儿童中并不罕见,它会导致慢性鼻塞,严重影响生活质量。本研究旨在探讨鼻甲缩小手术治疗药物治疗无效的下鼻甲肥大所致鼻呼吸障碍儿童的疗效和安全性。
我们纳入了 23 篇具有不同研究设计的文章:随机对照试验、单臂临床试验以及前瞻性和回顾性队列研究。我们在 2023 年 4 月 9 日之前使用相关关键词在 PubMed、Scopus、Cochrane 图书馆和 Web of Science 进行了检索。纳入标准为研究设计中预先设定了以下三个标准:研究对象为 18 岁以下接受任何技术进行鼻甲缩小的儿童,并评估了通过客观或主观方法改善的情况。
除了两项研究显示术前和术后结果无显著差异外,所有研究均使用客观测量方法来支持鼻甲手术。所有研究均使用主观测量方法显示术后有改善,除了一项研究。并发症发生率较低,常见的是结痂形成(6.03%),但该手术在儿童中总体上是安全的。此外,随访期从 2 周到 5 年以上不等。
鼻甲缩小术是治疗药物治疗无效的下鼻甲肥大引起的鼻塞的有效方法。它是一种安全的手术,并发症发生率低,但由于研究设计的异质性,可能存在偏倚风险,因此除了系统评价外,我们无法进行荟萃分析。