Our Summary

This research paper looks at the medical procedure known as septoplasty (surgery to correct a deviated septum in the nose) in children. Traditionally, doctors were cautious about performing this type of surgery on children because there was a risk that changes in growth after the operation could require additional surgery. However, recent research suggests that performing the operation early could prevent further complications related to growth.

The researchers examined data from the ACS NSQIP-P database for children who had undergone septoplasty between 2012 and 2019. They grouped the cases based on the primary procedure: cleft lip repair, sinus surgery, rhinoplasty/reconstruction/other, and septoplasty.

They found that 2290 patients were included in the study, with an average age of 14.2 years at the time of surgery. Patients who had cleft lip repair were significantly younger than those in the other groups. The most common health conditions found in these children were congenital malformation (20.0%) and asthma (10.2%).

The study also found that the total length of hospital stay was longer for younger patients, female patients, and patients with other health conditions. Also, a very small number of patients (0.3%) were readmitted within 30 days because of issues related to the septoplasty surgery, and 0.7% had to have further surgery within 30 days.

The conclusion of the research is that septoplasty is now being performed on children of all ages. The youngest patients tend to be those who are also undergoing cleft lip repair. While general complications like readmission and longer hospital stays are more common in younger children, the number of readmissions and further surgeries is relatively low. More research is needed to understand the long-term health effects of septoplasty in children.

FAQs

  1. What is the traditional view on performing septoplasty on children and has it changed recently?
  2. What were the most common health conditions found in children who underwent septoplasty according to the study?
  3. Based on the research, what are the common complications of septoplasty in children and how often do they occur?

Doctor’s Tip

A helpful tip a doctor might tell a patient about septoplasty is to follow post-operative care instructions carefully. This may include keeping the nasal passages moist with saline sprays, avoiding strenuous activities that could increase blood pressure, and using prescribed medications as directed. It is also important to attend follow-up appointments to monitor healing and address any concerns that may arise. By following these instructions, the patient can optimize their recovery and reduce the risk of complications.

Suitable For

Patients who are typically recommended septoplasty are those who have a deviated septum causing symptoms such as difficulty breathing, chronic nasal congestion, frequent nosebleeds, or recurrent sinus infections. Septoplasty may also be recommended for patients with nasal trauma or deformities that affect the nasal structure. In children, septoplasty may be recommended if the deviated septum is causing significant breathing problems or other symptoms that affect their quality of life. It is important for patients considering septoplasty to consult with an ENT specialist to determine if they are a suitable candidate for the procedure.

Timeline

Before septoplasty:

  1. Patient experiences symptoms of a deviated septum, such as difficulty breathing through the nose, frequent nosebleeds, and sinus infections.
  2. Patient consults with an ear, nose, and throat (ENT) specialist who recommends septoplasty to correct the issue.
  3. Patient undergoes pre-operative evaluations and tests to ensure they are healthy enough for surgery.
  4. Surgery date is scheduled and patient is instructed on pre-operative preparations such as fasting and medication adjustments.

After septoplasty:

  1. Patient undergoes the septoplasty surgery, which typically takes 1-2 hours and is performed under general anesthesia.
  2. Patient wakes up in the recovery room and is monitored for any complications.
  3. Patient may experience pain, swelling, and nasal congestion in the days following surgery.
  4. Patient follows post-operative instructions, which may include taking pain medication, using nasal sprays, and avoiding strenuous activities.
  5. Patient attends follow-up appointments with the ENT specialist to monitor progress and ensure proper healing.
  6. Patient gradually resumes normal activities and experiences improved nasal breathing and reduced symptoms related to the deviated septum.

What to Ask Your Doctor

Some questions a patient should ask their doctor about septoplasty include:

  1. What are the potential risks and complications associated with septoplasty in children?
  2. How will the surgery impact my child’s growth and development, especially if they are still young?
  3. How long is the recovery process expected to take, and what can we do to help facilitate a smooth recovery?
  4. Will my child need additional surgeries or treatments in the future as a result of the septoplasty?
  5. Are there any alternative treatments or procedures that could be considered for my child’s condition?
  6. What is the success rate of septoplasty in children, and what are the expected long-term outcomes?
  7. How experienced are you in performing septoplasty on children, and what is your success rate with pediatric patients?
  8. Are there any specific guidelines or restrictions my child will need to follow before and after the surgery to ensure the best results?
  9. How will the surgery impact my child’s ability to breathe and any related symptoms they may be experiencing?
  10. Can you provide me with any additional information or resources to help me better understand the procedure and what to expect for my child?

Reference

Authors: Raghavan M, Carr M. Journal: Int J Pediatr Otorhinolaryngol. 2022 Mar;154:111046. doi: 10.1016/j.ijporl.2022.111046. Epub 2022 Jan 19. PMID: 35085873