Abstract:
Corrective septal surgery for children with nasal obstruction has historically been avoided due to concern about the impact on the growing nose, with disruption of midfacial growth. However, there is a paucity of data evaluating complication and revision rates post-nasal septal surgery in the pediatric population. In addition, there is evidence to suggest that failure to treat nasal obstruction in children may itself result in facial deformity and/or developmental delay. The aim of this systematic review is to evaluate the efficacy and safety of septal surgery in pediatric patients with nasal obstruction. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. MEDLINE, Embase, and the Cochrane Library were searched. Original studies in pediatric patients (<18 years of age) with nasal obstruction were eligible for inclusion. Patients with cleft lip or palate as their primary diagnosis were excluded. Our primary outcomes were patient-reported outcome measures (PROMs), postsurgical complications, and revision rates. Secondary outcomes included surgical technique, anatomical considerations, and anthropometric measurements. Eighteen studies were included (1,080 patients). Patients underwent septoplasty, septorhinoplasty, rhinoplasty, or a combination of procedures for nasal obstruction. Obstruction was commonly reported secondary to trauma, nasal septal deviation, or congenital deformity. The mean age of the patients was 13.04 years with an average follow-up of 41.8 months. In all, 5.6% patients required revision surgery and there was an overall complication rate of 7.8%. Septal surgery for nasal obstruction in children has low revision and complication rates. However, a pediatric-specific outcome measure is yet to be determined. Larger prospective studies with long-term follow-up periods are needed to determine the optimal timing of nasal surgery for nasal obstruction in the pediatric population.
摘要:
由于担心鼻塞对鼻子生长的影响,儿童鼻中隔矫正手术历来被避免,面部中部生长中断。然而,在儿科人群中,缺乏评估鼻中隔手术后并发症和翻修率的数据.此外,有证据表明,儿童鼻塞治疗失败本身可能导致面部畸形和/或发育迟缓.这项系统评价的目的是评估鼻中隔手术在小儿鼻塞患者中的疗效和安全性。根据PRISMA指南进行了系统审查。MEDLINE,搜索了Embase和Cochrane图书馆。儿童鼻塞患者(<18岁)的原始研究符合纳入条件。排除以唇裂或腭裂为主要诊断的患者。我们的主要结果是患者报告的结果指标(PROMs),术后并发症和翻修率。次要结果包括手术技术,解剖学考虑和人体测量。纳入18项研究(1080例患者)。患者接受,中隔成形术,鼻中隔成形术,隆鼻,或程序的组合,鼻塞。据报道,通常继发于创伤,鼻中隔偏曲或先天性畸形。患者的平均年龄为13.04,平均随访时间为41.8个月。5.6%的患者需要翻修手术,总并发症发生率为7.8%。鼻中隔手术治疗儿童鼻塞的翻修率和并发症发生率较低。然而,儿科特异性结局指标尚待确定.需要进行长期随访的大型前瞻性研究,以确定儿科人群鼻塞鼻部手术的最佳时机。