Work

Does inferior turbinate reduction improve outcomes following adenotonsillectomy in pediatric OSA and allergic rhinitis patients?

Year: 2025

Type: article

Abstract: To evaluate persistent obstructive and allergic rhinitis (AR) symptoms in pediatric patients with concurrent sleep disordered breathing (SDB) and AR, comparing adenotonsillectomy (T&A) alone to T&A and inferior turbinate reduction (ITR). This retrospective cohort study examined patients ages 5-18 years who underwent T&A +/- ITR from 2007-2017. Exclusions were no AR (n=1,771), no SDB (n=170), no otolaryngology clinic note (n=60), tonsillectomy or adenoidectomy only (n=53), no follow-up (n=142), age <5 years (n=5), syndrome (n=9), concomitant airway surgery (n=3), and ITR before T&A (n=1). UPMC Children’s Hospital of Pittsburgh Chi-squared, Fisher’s exact, Wilcoxon rank-sum, Wilcoxon signed-rank, McNemar’s, and Spearman correlation tests were used (α=0.05). Of the 269 patients, 42 had T&A with ITR, and 227 had T&A only (median age: 12 years, range 5-18 years). Pre-T&A +/- ITR, common medications were oral antihistamines (112/269, 41.6%) and nasal corticosteroids (104/269, 38.7%). In the T&A only group, fewer patients used oral antihistamines post-operatively compared with pre-operatively (χ 2 (1)=30.6, p<0.001). In both the T&A only (χ 2 (1)=9.28, p=0.002) and T&A with ITR (χ 2 (1)=14.2, p<0.001) groups, fewer patients used nasal corticosteroids post-operatively. No significant differences in complications or post-op AR symptoms or sleep abnormalities were observed between groups. Seven T&A-only patients underwent ITR in the following 5 years. Both T&A with ITR and T&A alone resulted in reduced AR symptoms and improved AHI post-operatively. While no significant differences were observed in complications, post-op AR symptoms, or AHI between the groups, T&A with ITR significantly reduced post-operative nasal corticosteroid use. This study highlights the benefits of appropriate patient selection for T&A vs T&A with ITR in managing patients with SDB and AR.

Source: International Journal of Pediatric Otorhinolaryngology

DOI: 10.1016/j.ijporl.2025.112578