Efficacy and safety of inferior turbinates coblation in children

Bitar, Mohamed A.; Kanaan, Alyssa; Sinno, Sammy

doi:10.1017/s0022215114000206

Cited by 14 publications

(10 citation statements)

References 16 publications

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“…5 Of the prior studies showing a benefit of IT in the pediatric population, most did not control for concurrent airway procedures, making it difficult to assess the efficacy of the turbinate reduction alone. 1,2,[6][7][8][9] A few studies [10][11][12][13] have limited their study population to children undergoing inferior turbinate reduction alone, but these studies have small sample sizes and short followup. The present study aimed to assess the outcomes of pediatric patients undergoing isolated IT.…”

mentioning

confidence: 99%

Utility of Inferior Turbinoplasty for the Treatment of Nasal Obstruction in Children

Arganbright

Jensen

Mattingly

et al. 2015

JAMA Otolaryngol Head Neck Surg

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Inferior turbinoplasty showed overall utility and was safe and effective in the treatment of nasal obstruction in children for whom medical management had failed. No differences between surgical techniques were found in patient satisfaction, improvement of nasal patency, and recurrence, likely related to sample size. More than half of the patients continued to use medical therapy postoperatively, suggesting that inferior turbinate hypertrophy should not be considered solely as a surgical disease. Allergic rhinitis was identified as a significant comorbidity.

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mentioning

confidence: 99%

Utility of Inferior Turbinoplasty for the Treatment of Nasal Obstruction in Children

Arganbright

Jensen

Mattingly

et al. 2015

JAMA Otolaryngol Head Neck Surg

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“…37 Since then, multiple other studies have confirmed long-lasting improvement of nasal symptoms with low rates of postoperative crusting and epistaxis and no reports of synechiae or ozena (Table 2). 13,38,39 Furthermore, there is evidence that preoperative assessment may help differentiate patients who would most benefit from radiofrequency coblation. Yilmaz et al showed that the response to a preoperative topical vasoconstrictor drop test may predict long-term efficacy of RVTR in pediatric patients.…”

Section: Submucous Microdebridementmentioning

confidence: 99%

Inferior Turbinate Hypertrophy: A Review of the Evolution of Management in Children

Komshian

Cohen

Brook

et al. 2018

Am J Rhinol�Allergy

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Background Historically, there has been uncertainty in the treatment of inferior turbinate hypertrophy (ITH) in children. Although management always begins with medical therapy, the decision to offer surgery in resistant cases is becoming more widely practiced. In the pediatric population, turbinate reduction can be achieved with turbinectomy, electrocautery, lasers, submucous microdebridement, and radiofrequency volumetric tissue reduction (RVTR). However, there remains a lack of consensus on the preferred approach to treatment. Objective To compare how the efficacy, duration, and complications of different surgical methods has changed the management of inferior turbinate hypertrophy in children over time. Methods In March 2018, a comprehensive literature search was performed in PubMed for all inferior turbinate hypertrophy management-related studies in children. Inclusion criteria included children (age, 1–17 years). Exclusion criteria included reviews and abstracts. Results Each technique has experienced a period of popularity over the last 30 years in parallel with the technology available at the time as well as evidence from studies in adults. The literature for ITH management in children has largely followed these trends, with a recent improvement in the quality of studies mirroring the overall increase in surgical practice. Of all methods currently used, RVTR and submucous microdebridement offer the least invasive and most efficacious relief of nasal obstruction. Conclusion This review provides an overview of the evolution of ITH management in children and, based on historic and current evidence, proposes the following graduated recommendation to treatment: (1) a 3-month trial of medical management, (2) evaluation for adenoid hypertrophy for consideration of concurrent adenoidectomy, and (3) RVTR or submucous microdebridement as the first-line surgical approach.

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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%

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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Efficacy and safety of inferior turbinates coblation in children

Abstract: Inferior turbinate reduction by coblation is an effective and safe procedure in children aged six years and older. The positive outcomes seem to be long-lasting.

Cited by 14 publications

References 16 publications

Utility of Inferior Turbinoplasty for the Treatment of Nasal Obstruction in Children

Utility of Inferior Turbinoplasty for the Treatment of Nasal Obstruction in Children

Inferior Turbinate Hypertrophy: A Review of the Evolution of Management in Children

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

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