September 2019 HSC Section 1 Congenital and Pediatric Problems

A. Gupta et al. / International Journal of Pediatric Otorhinolaryngology 92 (2017) 11 e 16

Fig. 1. Literature search strategy.

Table 1 Overview of included studies.

Study

Year

Department

Patients (n)

Follow-up: mean (range)

Pierce et al.

2016 2013 1992 1985 2014 2011 2007

Plastic Surgery Otolaryngology

3

2 ( e )

Bae et al.

64 35 15 15 15

4.9 ( e )

Koltai et al.

Otolaryngology (Peds.)

! (0.5 e 5)

Crysdale et al. Chung et al.

Otolaryngology

e

Otolaryngology (Peds.) Otolaryngology (Peds.)

0.25 (0)

Locke et al.

! (0.25 e 6)

Shandilya et al.

Otolaryngology

106

! (1 e 13)

*All studies were retrospective chart reviews. Peds. ¼ Pediatric.

when judged by surgeons but low patient aesthetic satisfaction [1] . No perioperative complications were noted in one study [17] and in another study, 5/15 patients (33.3%) had poor or fair results (4/5 (80%) of these children had inadequate septal tissue at the time of surgery) [14] . In patients who underwent surgery to address valve stenosis, 100% (15/15 patients) reported satisfaction with improvement in their nasal obstructive symptoms at 90-day follow up visit [18] . In those children who were studied and underwent surgery for congenital lesions, all lesions (15/15 cases) were excised via an external rhinoplasty incision with all parents/guardians noting satisfaction with the appearance of the postoperative nose [19] . Complications of surgery were speci fi ed in 5 studies. There were a total of 57 patients out of 144 (39.6%) that had reported compli- cations. Seventeen patients (11.8%) noted aesthetic dissatisfaction, 8 (5.6%) had postoperative nasal obstruction, 6 (4.2%) had nasal

Table 2 Patient demographic characteristics.

Study

Age (y) e Mean (Range) Gender M/F (n) Nasal trauma (n)

Pierce et al.

NS

NS

NS 32

Bae et al.

NS (4 e 17) NS (0.6 e 18) 14.1 (6 e 17) 14 (6 e 15) 2.1 (1 e 5) NS (3 e 19)

46/18

Koltai et al.

NS

5

Crysdale et al. Chung et al.

10/5 10/5 12/3

13 10

Locke et al.

0

Shandilya et al.

66/40

NS

NS ¼ Not speci fi ed.

study of 106 did not comprehensively detail outcomes [16] . A well proportioned and appropriately shaped nasal tip postoperatively was noted in the group of patients who had excision of a nasal tip dermoid cyst with abdominal fat grafting but no speci fi c numeric measures were reported [15] . Another study noted positive results

Table 3 Surgical indications.

Type (n, %)

Speci fi c indication (n)

Mass (27, 10.7%) Aesthetic (48, 19%) Functional (16, 6.3%) Traumatic (29, 11.5%) Cleft Lip (40, 15.8%)

nasal dermoid (21), unidenti fi ed nasal mass (3), hemangioma (2), extranasal glioma (1) deviated nose (21), fl at nose (4), hump nose (2), cosmetic rhinoplasty for planned septoplasty (21)

septal deviation (11), unilateral choanal atresia (5)

nasal bone fracture (12), post-traumatic external or internal nasal valve collapse (10), traumatic nasoseptal deformity (7)

cleft lip nasal deformity (40)

Other (93, 36.8%)

functional aesthetic (62), functional (9), problems of the sphenoidal sinus (5), unknown (5), congenital nasal deformity (4), post-septoplasty revision (3), iatrogenic nasal stenosis (1), large hump and septoplasty revision (1), external septorhinoplasty revision (1), post-infectious nasal collapse (1), nasoseptal deformity (1)

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