(1014) Efficacy and Safety of Inferior Turbinoplasty Combined with Adenoidectomy in Pediatrics: Systematic Review and Meta-Analysis

Introduction: Nasal obstruction in pediatric patients represents a clinical challenge due to its multifactorial etiology and its adverse impact on quality of life, sleep patterns, and physical development. While adenoidectomy addresses pediatric nasal obstruction, concomitant turbinate hypertrophy may contribute to persistent symptoms. The efficacy and safety of inferior turbinectomy when combined with adenoidectomy (T+A) remains a subject of debate. Consequently, this systematic review aims to synthesize existing evidence and clarify the efficacy and safety.

Methods: A comprehensive literature search was in Scopus, Web of Science, MEDLINE, Embase, CENTRAL, Cochrane Database and PubMed, following PRISMA guidelines. Primary studies evaluating pediatric patients undergoing T+A were included. Extracted outcomes comprised demographics, quality-of-life measures, polysomnographic and acoustic rhinometric parameters and perioperative complications. A within-group meta-analysis was performed using standardized mean differences (SMD), calculated from pre- to post-intervention changes under a random-effects model.

Results: A total of 563 studies were identified. After screening by duplicate and independently, 19 met the inclusion criteria, and 7 studies (N= 307; mean age 9.54 ± 3.2 years) were included in the meta-analysis. Five studies evaluated polysomnographic and acoustic rhinometric outcomes, showing significant improvement following T+A (SMD = −1.46; 95% CI −2.32 to −0.61). Quality-of-life outcomes were also assessed in five studies, demonstrating marked postoperative improvement (SMD = −4.21; 95% CI −5.70 to −2.73). Postoperative bleeding was the most frequently reported complication, and no study reported the need for reintervention.

Conclusions: Turbinoplasty combined with adenoidectomy in pediatric patients is associated with significant improvements in quality of life and polysomnographic parameters, positively impacting lifestyle and overall well-being, with a low complication rate and no requirement for reintervention.