Impact of Combined Holmium:YAG Laser-Assisted Inferior Turbinate Reduction and Adenoidectomy on Pediatric Nasal Obstruction: A Prospective Study.
Source: PubMed, NCBI / U.S. National Library of Medicine
Pediatric nasal obstruction is most commonly caused by adenoid hypertrophy; however, inferior turbinate hypertrophy may contribute significantly to persistent nasal obstruction and may limit the effectiveness of adenoidectomy alone. This prospective comparative study evaluated the additional clinical value of Holmium:YAG (Ho:YAG) laser-assisted inferior turbinate reduction performed concurrently with adenoidectomy in children with nasal obstruction. Fifty-two children aged 6-12 years were enrolled between 2023 and 2025. Group 1 underwent adenoidectomy plus Ho:YAG turbinate reduction (n = 24), whereas Group 2 underwent adenoidectomy alone (n = 28). Acoustic rhinometry and OSA-18 quality-of-life scores were measured before surgery and at postoperative 3 months. Long-term follow-up was conducted for 15-24 months. Group 1 showed significantly greater improvements in minimal cross-sectional area and nasal volume compared with Group 2 (p < 0.001). OSA-18 total and subdomain scores improved in both groups but were significantly better in Group 1. Exploratory ROC analysis suggested that preoperative TNSS ≥9.5 and MCA ≤ 0.29 cmwere associated with clinician-based decision-making regarding inferior turbinate surgery. The combined procedure demonstrated a favorable safety profile with sustained clinical improvement. These findings suggest that, in selected pediatric patients with persistent nasal obstruction, addr
Abstract
Pediatric nasal obstruction is most commonly caused by adenoid hypertrophy; however, inferior turbinate hypertrophy may contribute significantly to persistent nasal obstruction and may limit the effectiveness of adenoidectomy alone. This prospective comparative study evaluated the additional clinical value of Holmium:YAG (Ho:YAG) laser-assisted inferior turbinate reduction performed concurrently with adenoidectomy in children with nasal obstruction. Fifty-two children aged 6-12 years were enrolled between 2023 and 2025. Group 1 underwent adenoidectomy plus Ho:YAG turbinate reduction (n = 24), whereas Group 2 underwent adenoidectomy alone (n = 28). Acoustic rhinometry and OSA-18 quality-of-life scores were measured before surgery and at postoperative 3 months. Long-term follow-up was conducted for 15-24 months. Group 1 showed significantly greater improvements in minimal cross-sectional area and nasal volume compared with Group 2 (p < 0.001). OSA-18 total and subdomain scores improved in both groups but were significantly better in Group 1. Exploratory ROC analysis suggested that preoperative TNSS ≥9.5 and MCA ≤ 0.29 cmwere associated with clinician-based decision-making regarding inferior turbinate surgery. The combined procedure demonstrated a favorable safety profile with sustained clinical improvement. These findings suggest that, in selected pediatric patients with persistent nasal obstruction, addressing turbinate hypertrophy may provide additional benefit in terms of nasal airflow and quality of life.