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 cm 2 were 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. • Combined surgery improved nasal airflow more than adenoidectomy alone. • Greater MCA and nasal volume gains with Ho:YAG turbinate reduction. • OSA-18 quality-of-life scores improved more with combined surgery. • Procedure showed favorable safety and sustained long-term outcomes. • Findings are exploratory due to non-randomized design and lack of PSG.
Alaskarov et al. (Fri,) studied this question.