Complications of turbinate reduction surgery in combination with tonsillectomy in pediatric patients

Yuen, Sonia N.; Leung, Peggy; Funamura, Jamie Lauren; Kawai, Kosuke; Roberson, David W.; Adil, Eelam

doi:10.1002/lary.26421

Cited by 10 publications

(3 citation statements)

References 20 publications

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“…With the available newer technologies such as microdebrider or radiofrequency performed as an intraturbinoplasty technique, such procedures can be performed as mucosalsparing methods with greater efficacy and minimal postoperative complications [50]. Remarkably, the mucosal-sparing approach has been shown to be safe and efficacious when performed concurrently with other procedures such as adenotonsillectomy [51]. Due to limited data and uncertainty over the long-term adverse effects, the decision to perform surgical turbinate reduction in children depends on clinical judgement and the preference of patients or their guardians/parents.…”

Section: Differences and Similarities Of Surgical Approach To Inferiomentioning

confidence: 99%

Surgical Interventions for Inferior Turbinate Hypertrophy: A Comprehensive Review of Current Techniques and Technologies

Abdullah

Singh

2021

IJERPH

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Surgical treatment of the inferior turbinates is required for hypertrophic inferior turbinates refractory to medical treatments. The main goal of surgical reduction of the inferior turbinate is to relieve the obstruction while preserving the function of the turbinate. There have been a variety of surgical techniques described and performed over the years. Irrespective of the techniques and technologies employed, the surgical techniques are classified into two types, the mucosal-sparing and non-mucosal-sparing, based on the preservation of the medial mucosa of the inferior turbinates. Although effective in relieving nasal block, the non-mucosal-sparing techniques have been associated with postoperative complications such as excessive bleeding, crusting, pain, and prolonged recovery period. These complications are avoided in the mucosal-sparing approach, rendering it the preferred option. Although widely performed, there is significant confusion and detachment between current practices and their basic objectives. This conflict may be explained by misperception over the myriad of available surgical techniques and misconception of the rationale in performing the turbinate reduction. A comprehensive review of each surgical intervention is crucial to better define each procedure and improve understanding of the principle and mechanism involved.

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Section: Differences and Similarities Of Surgical Approach To Inferiomentioning

confidence: 99%

Surgical Interventions for Inferior Turbinate Hypertrophy: A Comprehensive Review of Current Techniques and Technologies

Abdullah

Singh

2021

IJERPH

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“…Although not studied extensively, bilateral inferior turbinoplasty has been shown to be an effective, safe procedure in children that can potentially improve nasal congestion 7 and snoring, 8 and it does not significantly increase complication rates when performed concurrently with T/A. 9,10 Tonsillectomy/adenoidectomy with bilateral inferior turbinoplasty (T/A-BITR) has been demonstrated to significantly improve objective sleep parameters and subjective quality-of-life scores compared to T/A alone in the pediatric population. 11 Decision analysis can help further explore the potential success of T/A-BITR compared to the current standard of T/A.…”

mentioning

confidence: 99%

“…Chronic nasal obstruction in children induces mouth breathing in children, which may worsen obstructive sleep‐disordered breathing (oSDB) as well as further detract from quality of life. Although not studied extensively, bilateral inferior turbinoplasty has been shown to be an effective, safe procedure in children that can potentially improve nasal congestion 7 and snoring, 8 and it does not significantly increase complication rates when performed concurrently with T/A 9 , 10 . Tonsillectomy/adenoidectomy with bilateral inferior turbinoplasty (T/A‐BITR) has been demonstrated to significantly improve objective sleep parameters and subjective quality‐of‐life scores compared to T/A alone in the pediatric population 11 …”

mentioning

confidence: 99%

Cost Benefit and Utility Decision Analysis of Turbinoplasty with Adenotonsillectomy for Pediatric Sleep‐Disordered Breathing

Baik

Brietzke

2019

Otolaryngol.--head neck surg.

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Objectives Use decision analysis techniques to assess the potential utility gains/losses and costs of adding bilateral inferior turbinoplasty to tonsillectomy/adenoidectomy (T/A) for the treatment of obstructive sleep-disordered breathing (oSDB) in children. Use sensitivity analysis to explore the key variables in the scenario. Study Design Cost-utility decision analysis model. Setting Hypothetical cohort. Subjects and Methods Computer software (TreeAge Software, Williamstown, Massachusetts) was used to construct a decision analysis model. The model included the possibility of postoperative complications and persistent oSDB after surgery. Baseline clinical and quality-adjusted life year (QALY) parameters were estimated using published data. Cost data were estimated from Centers for Medicare and Medicaid 2018 databases ( www.cms.gov ). Sensitivity analyses were completed to assess for key model parameters. Results The utility analysis of the baseline model favored the addition of turbinoplasty (0.8890 vs 0.8875 overall utility) assuming turbinate hypertrophy was present. Sensitivity analysis indicated the treatment success increase (%) provided by concurrent turbinoplasty was the key parameter in the model. A treatment success increase of 3% of turbinoplasty was the threshold where concurrent turbinoplasty was favored over T/A alone. The incremental cost-effectiveness ratio (ICER) of $27,333/QALY for the baseline model was favorable to the willingness-to-pay threshold of $50,000 to $100,000/QALY for industrialized nations. Conclusions The addition of turbinoplasty for children with turbinate hypertrophy to T/A for the treatment of pediatric oSDB is beneficial from both a utility and cost-benefit analysis standpoint even if the benefits of turbinoplasty are relatively modest.

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Septoplasty and Turbinate Reduction in Children

Soneru

Riley

Gudis

2019

Pediatric Rhinosinusitis

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Complications of turbinate reduction surgery in combination with tonsillectomy in pediatric patients

Abstract: 4. Laryngoscope, 127:1920-1923, 2017.

Cited by 10 publications

References 20 publications

Surgical Interventions for Inferior Turbinate Hypertrophy: A Comprehensive Review of Current Techniques and Technologies

Surgical Interventions for Inferior Turbinate Hypertrophy: A Comprehensive Review of Current Techniques and Technologies

Cost Benefit and Utility Decision Analysis of Turbinoplasty with Adenotonsillectomy for Pediatric Sleep‐Disordered Breathing

Septoplasty and Turbinate Reduction in Children

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