Justification for Rhinoseptoplasty in Children – Our 10 Years Overview

Abstract

BACKGROUND:Nasal septal surgery and rhinoplasty are controversial in children. Traditionally, an attitude of restraint has been employed by most surgeons till an empirical age of 16 to 18 years. This is to avoid the possible adverse effects that the growth spurts may have on the nose and midface region.AIM:The aim of this paper was to present the results of rhinoplasty in children in order to restore the anatomy and function or to promote normal development and outgrowth of the nose.MATERIAL AND METHODS:Ninety seven children aged 6-14, with severe nose deformities and breathing problems through the nose, were admitted for septo/rhinoplasty at the University Clinic for Ear, Nose and Throat, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Republic of Macedonia. At our Clinic, they have been observed and photographed (with parent permission) in the period of 10 years (2006-2016). The most frequent cause of these deformities was the nasal trauma in early childhood which was ignored or untreated. All of them rhino/septoplasty were indicated in accordance with the above-mentioned recommendations for rhino/septoplasty in early childhood and in adolescents.RESULTS:In 51 children and adolescents septoplasty were prepared. Mostly there was a group of younger children age from 6-10 (68%) and adolescents (32%). In the other 31 children and adolescents, septorhinoplasty was prepared. Mostly there were children older than 12 years old and adolescents (70%). Only 30% were younger than 12 years, of course with severe nasal breathing problems, nasal septal deformities and deformities of the nasal pyramid.CONCLUSION:The growth centres of the nose have to be avoided if possible; long-term nasal issues will theoretically be minimised. If the surgeon replaces it, the cartilage of the nose becomes straighter but still intact.

Pediatric Rhinoplasty: A national surgical quality improvement program analysis

“…Few studies have explored the relationship between age and complication rates in rhinoplasty, but it is understood that young age should not preclude rhinoplasty if indicated. 3,6 In one study, long-term follow-up showed that nasal and facial growth were not adversely affected by surgery completed before age 12 years. 25 Another study showed that one early septorhinoplasty procedure had superior results to initial septoplasty, followed by a second-stage correction of the nasal pyramid.…”

“…In this rhinoplasty cohort, young age was a risk factor for complications. Few studies have explored the relationship between age and complication rates in rhinoplasty, but it is understood that young age should not preclude rhinoplasty if indicated . In one study, long‐term follow‐up showed that nasal and facial growth were not adversely affected by surgery completed before age 12 years .…”

“…Timing of surgery is controversial, with most surgeons traditionally waiting until females reach age 14 and males reach age 16 to avoid negatively impacting growth . However, there has been more recent evidence that ultimate facial proportions are not adversely affected by pediatric nasal surgery …”

“…3 However, there has been more recent evidence that ultimate facial proportions are not adversely affected by pediatric nasal surgery. 1,3,[6][7][8] Well-described complications of pediatric rhinoplasty include poor cosmetic result, nasal obstruction, and epistaxis. 4,9,10 However, research on pediatric rhinoplasty outcomes has been limited by small sample size, single institution studies, and inadequate information on procedural safety and quality.…”

Die endonasale endoskopische Resektion von Choanalatresien – wie groß ist der Langzeiterfolg?

“…Die großflächige Resektion rostraler Septumanteile sollte jedoch vermieden werden, da hierdurch das Risiko einer späteren Nasendeformität erhöht werden kann. Insbesondere der sphenodorsale Bereich zwischen Sphenoid und Nasenrücken hat Einfluss auf das Längen-und Höhenwachstum des Nasenrückens [19].…”