Evaluating utility of allergy testing in management of nasal obstruction following inferior turbinate reduction.

Autor: Lee J; Department of Otolaryngology, Nationwide Children's Hospital, Columbus, OH, USA; Department of Otolaryngology, The Ohio State University Medical Center, Columbus, OH, USA., McColl LF; Department of Otolaryngology, Nationwide Children's Hospital, Columbus, OH, USA; Department of Otolaryngology, The Ohio State University Medical Center, Columbus, OH, USA., Meeker MO; The Ohio State University College of Medicine, Columbus, OH, USA. Electronic address: molly.meeker@osumc.edu., Satroplus T; The Ohio State University College of Medicine, Columbus, OH, USA; Department of Otolaryngology, University of Nebraska Medical Center, Omaha, NE, USA., Kelly N; Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA., Liu K; Department of Otolaryngology, University of Florida Shands Hospital, Gainesville, FL, USA., Onwuka A; RTI International, Houston, TX, USA., Chiang T; Department of Otolaryngology, Nationwide Children's Hospital, Columbus, OH, USA; Department of Otolaryngology, The Ohio State University Medical Center, Columbus, OH, USA.
Jazyk: angličtina
Zdroj: International journal of pediatric otorhinolaryngology [Int J Pediatr Otorhinolaryngol] 2024 Nov 30; Vol. 188, pp. 112177. Date of Electronic Publication: 2024 Nov 30.
DOI: 10.1016/j.ijporl.2024.112177
Abstrakt: Introduction: Allergic rhinitis (AR) within the pediatric population affects more patients than any other chronic disease. Inferior turbinate hypertrophy (ITH) is a common cause of nasal obstruction in children and is strongly associated with AR. Inferior turbinate reduction (ITR) surgery is used in patients with ITH who have failed medical management. While surgery is curative for most, there remains a subset of patients who continue to have symptoms of nasal obstruction despite ITR, which can cause discomfort and significant impacts on quality of life. Additionally, some patients with persistent disease go on to require revision surgery. The objectives in this study were to assess the impact of allergy testing results in patients undergoing ITR and evaluate if they predict long-term durability of surgical outcome.
Methods: A retrospective chart review of patients undergoing ITR between January and December of 2015 was performed. Data pertaining to demographics, allergy testing results, surgical technique, and medical management was collected. Patients who underwent concomitant procedures at the time of ITR were excluded. Data analysis included descriptive statistics, chi-squared tests, and t-test analyses.
Results: 297 patients who underwent ITR were included for data analysis. Overall, 20.9 % of patients had recurrent nasal obstruction after ITR and 5.4 % required revision surgery. Among all included patients, 37.7 % underwent allergy testing of which 53 (47.3 %) tested positive and 54 (48.2 %) tested negative; results were unknown for 5 (4.5 %) patients. In patients with positive allergy tests, 36 % had recurrent nasal obstruction and 11 % required revision surgery. In patients with negative allergy tests, 41 % had recurrent nasal obstruction and 13 % required revision surgery. There were no significant associations among those with positive and negative allergy tests and recurrence of nasal obstruction or need for revision surgery. Patients with a documented clinical diagnosis of AR were more likely to have recurrence of nasal obstruction after surgery than those without (28 % vs 12 %, p = 0.001) and were more likely to require revision surgery (9 % vs 1 %, p = 0.001).
Conclusions: ITR is a reasonable choice for the treatment of nasal obstruction in children. However, there remains a subset of patients who have recurrent nasal obstruction following initial surgery. Allergy testing results do not appear to impact the rate of recurrent nasal obstruction or the need for revision surgery. Therefore, the utility of allergy testing may have a limited benefit in the management of nasal obstruction in children. However, a clinical diagnosis of allergic rhinitis does appear to be a prognostic factor for experiencing post-operative recurrent nasal obstruction and requiring revision surgery.
Competing Interests: Declaration of competing interest Joseph Lee, MD: Nothing to declare. Logan F. McColl, MD, MBA: Nothing to declare. Molly O. Meeker, BS: Nothing to declare. Tony Satroplus, MD: Nothing to declare. Natalie Kelly, BS: Nothing to declare. Kevin Liu, MD: Nothing to declare. Amanda Onwuka, PhD: Nothing to declare. Tendy Chiang, MD: Nothing to declare.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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