Abstract
Nasal obstruction in the pediatric patient can lead to decreased quality of life and contribute to sleep disordered breathing. In severe cases with prolonged obligate mouth breathing, it may even lead to dental and craniofacial abnormalities. In children who present with nasal obstruction, a thorough physical exam and nasal endoscopy should be performed with particular attention to the nasal septum and inferior turbinates. If symptoms persist despite appropriate medical therapy, surgery should be considered. A septoplasty may be performed safely and effectively with good evidence that the procedure does not affect craniofacial development if performed with meticulous surgical techniques. Inferior turbinate reduction may be performed in a variety of ways, although most modern techniques avoid destruction of the overlying mucosa.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Linder-Aronson S. Adenoids: their effect on mode of breathing and nasal airflow and their relationship to characteristics of the facial skeleton and the dentition. A biometric, rhino-manometric and cephalometro-radiographic study on children with and without adenoids. Acta Otolaryngol Suppl. 1970;265:1–132.
Luzzi V, Di Carlo G, Saccucci M, et al. Craniofacial morphology and airflow in children with primary snoring. Eur Rev Med Pharmacol Sci. 2016;20(19):3965–71.
Bresolin D, Shapiro PA, Shapiro GG, Chapko MK, Dassel S. Mouth breathing in allergic children: its relationship to dentofacial development. Am J Orthod. 1983;83(4):334–40.
D’ascanio L, Lancione C, Pompa G, Rebuffini E, Mansi N, Manzini M. Craniofacial growth in children with nasal septum deviation: a cephalometric comparative study. Int J Pediatr Otorhinolaryngol. 2010;74(10):1180–3.
Pentz S, Pirsig W, Lenders H. Long-term results of neonates with nasal deviation: a prospective study over 12 years. Int J Pediatr Otorhinolaryngol. 1994;28(2–3):183–91.
Brietzke S, Shin J, Choi S, et al. Clinical consensus statement: pediatric chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2014;151(4):542–53.
Van Loosen J, Van Zanten GA, Howard CV, Verwoerd-Verhoef HL, Van Velzen D, Verwoerd CD. Growth characteristics of the human nasal septum. Rhinology. 1996;34(2):78–82.
Mynatt RG, Sindwani R. Surgical anatomy of the paranasal sinuses. In: Stucker FJ, de Souza C, Kenyon GS, Lian TS, Draf W, Schick B, editors. Rhinology and facial plastic surgery. Berline: Springer; 2009.
Kohlberg GD, Stewart MG, Ward RF, April MM. Evaluation and management of pediatric nasal obstruction: a survey of practice patterns. Am J Rhinol Allergy. 2016;30:274–8.
Izquierdo-Dominguez A, Valero AL, Mullol J. Comparative analysis of allergic rhinitis in children and adults. Curr Allergy Asthma Rep. 2013;13:142–51.
Bousquet J, Khaltaev N, Cruz AA, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008 update. Allergy. 2008;63:8–160.
Montoro J, Del Cuvillo A, Mullol J, et al. Validation of the modified allergic rhinitis and its impact on asthma (ARIA) severity classification in allergic rhinitis children: the PEDRIAL study. Allergy. 2012;67:1436–42.
Marino-Sanchez FS, Valls-Mateus M, Ruiz-Echevarria K, Alobid I, Cardenas-Escalante P, Jimenez-Feijoo R, Lozano-Blasco J, et al. Nasal obstructive disorders induce medical treatment failure in pediatric persistent allergic rhinitis (the NODPAR study). Pediatr Allergy Immune. 2017;28:176–84.
Suratt PM, Turner BL, Wilhoit SC. Effect of intranasal obstruction on breathing during sleep. Chest. 1986;90:324–9.
Lipton AJ, Gozal D. Treatment of obstructive sleep apnea in children: do we really know how? Sleep Med Rev. 2003;7:61–80.
Fick L. Uber die Ursachen der Knochenforman: Experimental Untersuchung. Wigand GH: Gottingen; 1858.
Landsberger R. Die triebende Krafte zur Dehnung und Streckung des Gesichtschadels. Zahnarztliche Runschau. 1929;23:978–90.
Sarnat BG, Wexler MR. Growth of the face and jaws after resection of the septal cartilage in the rabbit. Am J Anat. 1966;118:755–67.
Bernstein L. Early submucous resection of nasal septal cartilage: a pilot study in canine pubs. Arch Otolaryngol. 1973;97(3):273–8.
Cupero TM, Middleton CE, Silva AB. Effects of functional septoplasty on the facial growth of ferrets. Arch Otolaryngol Head Neck Surg. 2001;127(11):1367–9.
Jugo SB. Total septal reconstruction through decortication (external) approach in children. Arch Otolaryngol Head Neck Surg. 1987;113(2):173–8.
Triglia JM, Cannoni M, Pech A. Septorhinoplasty in children: benefits of the external approach. J Otolaryngol. 1990;19(4):274–8.
Bejar I, Farkas LG, Messner AH, Crysdale WS. Nasal growth after external septoplasty in children. Arch Otolaryngol Head Neck Surg. 1996;122:816–21.
El-Hakim H, Crysdale WS, Abdollel M, Farkas LG. A study of anthropometric measures before and after external septoplasty in children: a preliminary study. Arch Otolaryngol Head Neck Surg. 2001;127:1362–6.
Tasca I, Compadretti GC. Nasal growth after pediatric septoplasty at long-term follow-up. Am J Rhinol Allergy. 2011;25:e7–e12.
Christophel JJ, Gross CW. Pediatric Septoplasty. Otolaryngol Clin N Am. 2009;42:287–94.
Crysdale WS, Walker PJ. External septorhinoplasty in children: patient selection and surgical technique. J Otolaryngol. 1994;23:28–31.
Sooknundun M, Kacker SK, Bhatia R, Deka RC. Nasal septal deviation: effective intervention and long term follow-up. Int J Pediatr Otorhinolaryngol. 1986;12(1):65–72.
Chivukula S, Koutourousiou M, Snyderman CH, Fernandez-Miranda JC, Gardner PA, Tyler-Kabara EC. Endoscopic endonasal skull base surgery in the pediatric population. J Neurosurg Pediatr. 2013;11:227–41.
Dispenza F, Saraniti C, Sciandra D, Kulamarva G, Dispenza C. Management of nasoseptal deformity in childhood: long-term results. Auris Nasus Larynx. 2009;36:665–70.
Yilmaz MS, Guven M, Akidil O, Kayabasoglu G, Demir D, Mermer H. Does septoplasty improve the quality of life in children? Int J Pediatr Otorhinolaryngol. 2014;78:1274–6.
Lee VS, Gold RM, Parikh SR. Short-term quality of life outcomes following pediatric septoplasty. Acta Otolaryngol. 2017;137(3):293–6.
Segal S, Eviatar E, Berenholz L, Kessler A, Shlamkovitch N. Inferior turbinectomy in children. Am J Rhinol. 2003;17(2):69–73.
Nurse LA, Duncavage JA. Surgery of the inferior and middle turbinates. Otolaryngol Clin N Am. 2009;42(2):295–309.
Janda P, Stroka R, Baumgartner R. Laser treatment of hyperplastic inferior nasal turbinates: a review. Lasers Surg Med. 2001;28:404–14.
Utley DS, Goode RL, Hakim I. Radiofrequency energy tissue ablation for the treatment of nasal obstruction secondary to turbinate hypertrophy. Laryngoscope. 1999;109:683–6.
Bhattacharyya N, Kepnes LJ. Clinical effectiveness of coblation inferior turbinate reduction. Otolaryngol Head Neck Surg. 2003;129:365–71.
Bitar MA, Kanaan AA, Sinno S. Efficacy and safety of inferior turbinate coblation in children. J Laryngol Otol. 2014;128(Suppl 2):S48–54.
Friedman M, Tanyeri H, Lim J, Landsberg R, Caldarelli D. A safe, alternative technique for inferior turbinate reduction. Laryngoscope. 1999;109(11):1834–7.
Acevedo JL, Camacho M, Brietzke SE. Radiofrequency ablation turbinoplasty versus microdebrider-assisted turbinoplasty: a systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2015;153(6):951–6.
Leong SC, Kubba H, White PS. A review of outcomes following inferior turbinate reduction surgery in children for chronic nasal obstruction. Int J Pediatr Otorhinolaryngol. 2010;74:1–6.
Cheng PW, Fang KM, Su HW, Huang TW. Improved objective outcomes and quality of life after adenotonsillectomy with inferior turbinate reduction in pediatric obstructive sleep apnea with inferior turbinate hypertrophy. Laryngoscope. 2012;122(12):2850–4.
Arganbright JM, Jensen EL, Mattingly J, Gao D, Chan KH. Utility of inferior turbinoplasty for the treatment of nasal obstruction in children: a 10-year review. JAMA Otolaryngol Head Neck Surg. 2015;141(10):901–4.
Jiang ZY, Pereira KD, Friedman NR, Mitchell RB. Inferior turbinate surgery in children: a survey of practice patterns. Laryngoscope. 2012;122:1620–3.
Langille M, El-Hakim H. Pediatric inferior turbinoplasty with or without adenoidectomy: preliminary report on improvement of quality of life, symptom control, and safety. Otolaryngol Head Neck Surg. 2011;40:420–6.
Yuen SN, Leung PP, Funamura J, Kawai K, Roberson DW, Adil EA. Complications of turbinate reduction surgery in combination with tonsillectomy in pediatric patients. Laryngoscope. 2017;127:1920–3.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Soneru, C.P., Riley, C.A., Gudis, D.A. (2020). Septoplasty and Turbinate Reduction in Children. In: Ramadan, H., Baroody, F. (eds) Pediatric Rhinosinusitis. Springer, Cham. https://doi.org/10.1007/978-3-030-22891-0_19
Download citation
DOI: https://doi.org/10.1007/978-3-030-22891-0_19
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-22890-3
Online ISBN: 978-3-030-22891-0
eBook Packages: MedicineMedicine (R0)