Skip to main content
AAO-HNSF 2024 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back

Scientific Oral Presentations

Pediatric Otolaryngology

Session: Scientific Oral Presentations 6 - Pediatric Otolaryngology

Does Inferior Turbinate Reduction Improve Outcomes Following Adenotonsillectomy in Pediatric Obstructive Sleep Apnea and Allergic Rhinitis Patients?

Monday, September 30, 2024
3:12 PM – 3:18 PM EDT
Location: MBCC, 225
Disclosure(s):
Pooja D. Reddy, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Brian D. Ocasio-Nieves, Student:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jiage Qian, MSPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Amber D. Shaffer, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Amanda L. Stapleton, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Adenotonsillectomy (T&A) is the primary intervention for pediatric sleep-disordered breathing (SDB), while inferior turbinate reduction (ITR) is effective in managing nasal obstruction associated with allergic rhinitis (AR). This study evaluates persistent nasal obstruction and AR symptoms in pediatric patients with concurrent SDB and AR, comparing T&A alone to T&A with ITR.

Methods: This retrospective cohort study examined patients ages 5-18 years who underwent T&A with or without ITR at a tertiary children’s hospital from 2007-2017. Exclusions were no AR (n=1,753), no SDB (n=147), no follow-up (n=52), syndrome (n=4), and concomitant airway surgery (n=1). Logistic regression or Wilcoxon rank-sum compared demographic and clinical characteristics. Symptoms pre- and post-operatively were assessed using McNemar or Wilcoxon signed-rank tests (α=0.05).

Results: Of the 137 patients identified, 28 had T&A with ITR, and 109 had T&A only (median age: 14 years). Pre-operatively, 42.3% of all surgical patients were on oral antihistamines and 40.9% on nasal corticosteroids. Post-op, both medications decreased (oral antihistamines: 17.1%, OR: 8.00, 95% CI: 2.84-31.1; nasal corticosteroids: 25.2%, OR: 3.20, 95% CI: 1.53-7.30). AR symptoms significantly decreased in both groups (p < 0.05) and median AHI reduced from 16.0 to 2.9 (p < 0.001). T&A + ITR significantly reduced nasal corticosteroid use (pre: 75.0% vs post: 29.6%, OR: 12.5, 95% CI: 3.12-109). No significant differences in complications, post-op AR symptoms, or post-op sleep abnormalities were observed between groups. Additionally, no T&A-only patients underwent ITR in the following 5 years.

Conclusions: 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 + ITR in managing pediatric patients with SDB and AR.

    Presenting Author(s)

  • Pooja D. Reddy, BS

    Medical Student
    University of Pittsburgh School of Medicine
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Brian D. Ocasio-Nieves, Student

    Student
    University of Pittsburgh School of Medicine
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • JQ

    Jiage Qian, MSPH

    Student
    University of Pittsburgh School of Medicine
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • AS

    Amber D. Shaffer, PhD

    Research Assistant Professor
    UPMC Children's Hospital of Pittsburgh
    Pittsburgh, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • MR

    Marina V. Rushchak

    Research Coordinator
    University of Pittsburgh Medical Center Department of Otolaryngology
    Pittsburgh, PA, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Amanda L. Stapleton, MD

    Associate Professor of Otolaryngology
    University of Pittsburgh Medical Center Department of Otolaryngology
    Pittsburgh, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.