Christian Calvo-Henriquez1,2, Miguel Mayo-Yáñez3,4, Jerome R Lechien3,5, Jose Domingo Moure6, Ana Faraldo-García3,7, Gabriel Martinez-Capoccioni3,7, Eduard Esteller-More8,9, Jose Carlos Neves10, Carlos Martin-Martin7. 1. Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Rhinology Study Group, Paris, France. christian.ezequiel.calvo.henriquez@sergas.es. 2. Service of Otolaryngology, Rhinology Section, Hospital Complex of Santiago de Compostela, s/n. 15706, Santiago de Compostela, Spain. christian.ezequiel.calvo.henriquez@sergas.es. 3. Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Rhinology Study Group, Paris, France. 4. Service of Otolaryngology, Hospital Complex of La Coruña, A Coruña, Spain. 5. Service of Otolaryngology, Foch Hospital, University of Paris Saclay, Paris,, France. 6. Department of Pediatric Pneumology, Allergy Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain. 7. Service of Otolaryngology, Rhinology Section, Hospital Complex of Santiago de Compostela, s/n. 15706, Santiago de Compostela, Spain. 8. Service of Otolaryngology, General University Hospital of Catalonia, Barcelona, Spain. 9. Department of Otolaryngology, International University of Catalonia, Barcelona, Spain. 10. MyFace Clinics and Academy, Lisbon, Portugal.
Abstract
OBJECTIVE: The main causes for objectively confirmed chronic impaired nasal breathing in children are adenoid and turbinate hypertrophy. Turbinate hypertrophy may be addressed by turbinate surgery. However, specialized guidelines include no specific indications for pediatric patients. The decongestant test consists of simulating the effect of turbinate surgery by means of a nasal decongestant. This project, developed by the YO-IFOS rhinology group, aims to establish a cutoff value for the nasal decongestant test with rhinomanometry to select children for turbinate surgery. METHODS: Children between 4 and 15 years of age were included. Cases were consecutively selected from children affected by turbinate hypertrophy undergoing turbinate radiofrequency ablation with or without adenoidectomy. Controls were consecutively selected from a sample of healthy children. All the subjects were examined with anterior active rhinomanometry with and without nasal decongestant. RESULTS: Sample included 72 cases and 24 healthy controls. There was a statistically significant difference in the improvement with the decongestant between cases (57.91%) and controls (15.67%). The ROC curve revealed an area under the curve of 0.97. The highest amount of correctly classified individuals (93.44%) corresponded to the cutoff value of 31.66%. However, the value with the highest specificity and highest Youden's index was the 38.88% improvement in nasal resistance with nasal decongestant. CONCLUSIONS: In conclusion, a preliminary cutoff value for the decongestant test used with rhinomanometry in children has been established. This test could help identify children for turbinate surgery.
OBJECTIVE: The main causes for objectively confirmed chronic impaired nasal breathing in children are adenoid and turbinate hypertrophy. Turbinate hypertrophy may be addressed by turbinate surgery. However, specialized guidelines include no specific indications for pediatric patients. The decongestant test consists of simulating the effect of turbinate surgery by means of a nasal decongestant. This project, developed by the YO-IFOS rhinology group, aims to establish a cutoff value for the nasal decongestant test with rhinomanometry to select children for turbinate surgery. METHODS:Children between 4 and 15 years of age were included. Cases were consecutively selected from children affected by turbinate hypertrophy undergoing turbinate radiofrequency ablation with or without adenoidectomy. Controls were consecutively selected from a sample of healthy children. All the subjects were examined with anterior active rhinomanometry with and without nasal decongestant. RESULTS: Sample included 72 cases and 24 healthy controls. There was a statistically significant difference in the improvement with the decongestant between cases (57.91%) and controls (15.67%). The ROC curve revealed an area under the curve of 0.97. The highest amount of correctly classified individuals (93.44%) corresponded to the cutoff value of 31.66%. However, the value with the highest specificity and highest Youden's index was the 38.88% improvement in nasal resistance with nasal decongestant. CONCLUSIONS: In conclusion, a preliminary cutoff value for the decongestant test used with rhinomanometry in children has been established. This test could help identify children for turbinate surgery.