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Looking for a cutoff value for the decongestant test in children suffering with turbinate hypertrophy

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

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.

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Correspondence to Christian Calvo-Henriquez.

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This work is part of the research completed by Christian Calvo-Henriquez, MD, to obtain a PhD degree. The rest of the authors declare no disclosure or conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Calvo-Henriquez, C., Mayo-Yáñez, M., Lechien, J.R. et al. Looking for a cutoff value for the decongestant test in children suffering with turbinate hypertrophy. Eur Arch Otorhinolaryngol 278, 3821–3826 (2021). https://doi.org/10.1007/s00405-021-06657-0

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  • DOI: https://doi.org/10.1007/s00405-021-06657-0

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