Pediatric nasal surgery: timing and technique

Abstract

Pediatric nasal surgery prior to puberty is not only safe, but may prevent facial deformity in certain patients.

Pediatric nasal septoplasty outcomes

“…This is in contrast with the findings of a recent retrospective review of 43 preadolescent children (defined as males <16 years, females <14 years) who received septoplasty that found that 0 of these patients required revision procedures (1). Other published studies report similarly favorable long-term outcomes in this population (4,5). Similarly, a review of pediatric nasal surgery has demonstrated that conservative and limited nasal surgery with careful preservation of septal structure may be safely performed in the pediatric population with little longterm impact on nasofacial growth (16).…”

“…The septal cartilage plays a major role in growth and development of the midface. Specifically, the sphenodorsal zone increases the length and height of the nasal bones, while the sphenospinal zone increases maxilla outgrowth (4,5). As a result, surgeons have adopted a cautious attitude towards correction of nasal septal deformities in the pediatric population, often electing to wait until puberty to perform the procedure (3).…”

“…As a result, surgeons have adopted a cautious attitude towards correction of nasal septal deformities in the pediatric population, often electing to wait until puberty to perform the procedure (3). Based on completion of nasal growth, safe timeframes for nasal surgery have been estimated to be 16 years of age in boys and 14 years of age in girls (5).…”

“…Besides the benefits of enhanced nasal function, improvements in quality-of-life have been reported in the pediatric population (12,13). Authors have used this data to advocate for early corrective surgery to provide harmonious growth and prevent craniofacial sequelae of mouth breathing (5,6). Some studies have suggested that septal surgery is safe in children as young as 6-years-old, and may even be considered in neonates if severe airway obstruction is present (2,4).…”

“…Some studies have suggested that septal surgery is safe in children as young as 6-years-old, and may even be considered in neonates if severe airway obstruction is present (2,4). When the procedure is deemed necessary, a conservative approach to cartilage scoring and resection is thought to avoid disruption of the primary nasal and midface growth centers, and thus prevent the need for revision surgery later in life (5,14).…”