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Inicio Acta Otorrinolaringológica Española Turbinate surgery in pediatric patients: A worldwide survey
Journal Information
Vol. 74. Issue 2.
Pages 93-100 (March - April 2023)
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Vol. 74. Issue 2.
Pages 93-100 (March - April 2023)
Original article
Turbinate surgery in pediatric patients: A worldwide survey
Cirugía de cornetes en población pediátrica: una encuesta global
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Christian Calvo-Henriqueza,b,
Corresponding author
, Manuel Tucciaronea,c, Jerome R. Lechiena,d, Antonino Maniacia,e, Elise Grahama,f, Juan Maza-Solanoa,g, Osama Metwalya,h, Gabriel Martinez-Capoccionia,b, Franklin Mariño-Sancheza,i, Guillermo Plazaj, Carlos Martin-Martinb
a Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
b Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
c Hospital Universitario de Jerez, Jerez, Spain
d Service of Otolaryngology, Foch Hospital, University of Paris Saclay, Paris, France
e Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, ENT Department of University of Catania, Catania, Italy
f London Health Sciences Centre – Victoria Hospital, Ontario, Canada
g Rhinology and Skull Base Surgery Unit, Otolaryngology Department, University Hospital Virgen Macarena, University of Seville, Seville, Spain
h Kasr Alainy School of Medicine, Cairo University, Egypt
i Rhinology and Skull Base Surgery Unit, Otolaryngology Department, Hospital Ramon y Cajal, Madrid, Spain
j Otolaryngology Department, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Madrid, Spain
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Abstract
Objective

Impaired nasal breathing is a common condition among pediatric patients, being rhinitis the most common cause. In recent years, turbinate surgery, mainly turbinate radiofrequency ablation (TRA), has increased in popularity amongst pediatric otolaryngologists and rhinologists as a safe and useful technique to address turbinate hypertrophy in pediatric patients. The present paper is designed with the aim of assessing the current worldwide clinical practice regarding turbinate surgery in pediatric patients.

Methods

The questionnaire was developed based on previous researches, by a group of 12 experts from the rhinology and pediatric otolaryngology research group belonging to the Young Otolaryngologists of the International Federation of Otorhinolaryngological societies (YO-IFOS). The survey was then translated to 7 languages and sent to 25 scientific otolaryngologic societies around the globe.

Results

15 scientific societies agreed to distribute the survey to their members. There were 678 responses from 51 countries. From them, 65% reported to usually perform turbinate surgery in pediatric patients. There was a statistically significant increased likelihood of performing turbinate surgery for those practicing rhinology, sleep medicine, and/or pediatric otolaryngology compared to other subspecialties. The main indication to perform turbinate surgery was nasal obstruction (93.20%); followed by sleep disordered breathing (53.28%), chronic rhinosinusitis (28.70%) and facial growth alterations (22.30%).

Conclusions

There is no general consensus on the indications and ideal technique for turbinate reduction in children. This dissension arises mainly from the lack of scientific evidence. The points with highest agreement (>75%) between respondents is the use of nasal steroids prior to surgery; reintroducing nasal steroids in allergic patients; and performing turbinate surgery as day-case surgery.

Keywords:
Turbinate radiofrequency ablation
Rhinitis
Turbinate surgery
Turbinectomy
Turbinoplasty
Resumen
Objetivo

La obstrucción nasal es una enfermedad habitual en pacientes pediátricos, siendo la rinitis la causa más frecuente. En los últimos años la cirugía de cornetes, especialmente la radiofrecuencia (RF), ha aumentado su popularidad entre los otorrinolaringólogos pediátricos y los rinólogos como una técnica segura y eficaz para tratar esta enfermedad en población pediátrica. Este artículo se diseña con el objetivo de evaluar la práctica clínica habitual a este respecto a nivel global.

Métodos

El cuestionario fue diseñado basado en trabajos previos por un grupo de 12 expertos del Grupo de Investigación en Rinología y en Otorrinolaringología Pediátrica de la Young Otolaryngologists of the International Federation of Otorhinolaryngological societies (YO-IFOS). La encuesta fue traducida a 7 idiomas y enviada a 25 sociedades científicas.

Resultados

Quince sociedades científicas aceptaron distribuir la encuesta entre sus miembros. Hubo 678 respuestas de 51 países. De ellos, el 65% comunicó realizar de manera habitual cirugía de cornetes en población pediátrica. Se observó una mayor probabilidad de realizar la intervención entre especialistas en Rinología, Medicina del sueño u Otorrinolaringología pediátrica comparado con el resto de las subespecialidades. La indicación más habitual para realizar la cirugía fue obstrucción nasal (93,20%), seguida por trastorno respiratorio del sueño (53,28%), rinosinusitis crónica (28,70%) y alteraciones del desarrollo facial (22,30%).

Conclusiones

No existe un consenso general en las indicaciones ni en la técnica quirúrgica de elección para esta cirugía en pacientes pediátricos. La desavenencia nace principalmente de la falta de evidencia científica. Los puntos con mayor acuerdo (> 75%) entre los respondedores fueron el uso de corticoide tópico nasal previo a la cirugía; reintroducir la medicación tópica en pacientes alérgicos, y realizar la cirugía de manera ambulatoria.

Palabras clave:
Radiofrecuencia de cornetes
Rinitis
Cirugía de cornetes
Turbinectomía
Turbinoplastia

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