Adenotonsillectomy with turbinate ablation shows no added benefit for pediatric SDBSubmucosal ablation adds little benefit to adenotonsillectomy for children

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery Published May 1, 2026 Study authors: Bharadwaj Suhas, Vazifedan Turaj, Baldassari Cristina M PubMed ↗ DOI ↗ Editorial oversight: Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

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Key Takeaway

Consider that adding submucosal ablation of turbinates to adenotonsillectomy may not improve nasal quality of life in children with SDB.

This randomized prospective study included 51 children aged 3 to 17 years with sleep-disordered breathing (SDB), nasal obstruction, and turbinate hypertrophy. Participants were randomized to adenotonsillectomy with submucosal ablation of turbinates (AT with SAT) or adenotonsillectomy alone (AT). The primary outcome was change in the sinus and nasal quality of life survey (SN-5) at 3 and 12 months.

At 3 months, the reduction in total SN-5 score was 51% in the AT with SAT group versus 50.1% in the AT alone group (P = .707). At 12 months, the reduction was 52.1% versus 43.6% (P = .225). Neither difference was statistically significant. The visual analog scale (VAS) was a secondary outcome, but specific results were not reported.

Safety and adverse events were not reported in the study. A key limitation is that the SAT group had higher preoperative SN-5 scores compared to the control group, which may have influenced results. The authors note that future research should include an assessment of SDB symptom burden.

For clinicians, it remains uncertain whether SAT performed at the time of AT confers additional improvement in nasal symptoms compared to AT alone. These findings do not support routine addition of SAT in this population.

This randomized prospective study looked at children between 3 and 17 years old who had sleep-disordered breathing and nasal obstruction. The researchers compared adenotonsillectomy alone against adenotonsillectomy combined with submucosal ablation of the turbinates. The group receiving the additional turbinate procedure started with higher preoperative scores on the nasal quality of life survey.

At both 3 months and 12 months, there was no statistically significant difference in the reduction of nasal quality of life scores between the two groups. The p-values were .707 at 3 months and .225 at 12 months. No adverse events or discontinuations were reported in this small sample of 51 patients.

The main reason to be careful is that the study was small and the groups were not perfectly balanced at the start. It remains uncertain whether adding turbinate surgery provides extra improvement in nasal symptoms compared to adenotonsillectomy alone. Future research should include an assessment of sleep-disordered breathing symptom burden to better understand the role of this additional procedure.

What this means for you:

Adding turbinate ablation to adenotonsillectomy did not significantly improve nasal quality of life scores in children.

Study Details

Study typeRct

Sample sizen = 51

EvidenceLevel 2

Follow-up204.0 mo

PublishedMay 2026

PMID41879315

View Original Abstract ↓

OBJECTIVE: To assess whether submucosal ablation of turbinates (SAT) at the time of adenotonsillectomy (AT) confers benefit in the reduction of nasal obstruction compared to AT alone. STUDY DESIGN: A randomized, single-blinded study between 2014 and 2017. Children between 3 and 17 years with sleep-disordered breathing (SDB) and nasal obstruction were eligible. Patients had turbinate hypertrophy at baseline and were scheduled to undergo AT for SDB. The sinus and nasal quality of life survey (SN-5) and the visual analog scale (VAS) were measured. SETTING: Tertiary Children's Hospital. METHODS: Children were randomized to AT (control group) or AT with SAT. The study was powered to assess for changes in the SN-5 at 3 and 12 months. RESULTS: In total, 51 patients were randomly assigned: 18 in the control group and 33 in the AT with SAT group. The SAT group had higher preoperative SN-5 scores compared to the control group. Both groups experienced improvement in SN-5 scores at 3 and 12 months. There was no statistically significant difference in the reduction of the total SN-5 score at 3 months (51% vs 50.1%, P = .707) and 12 months (52.1% vs 43.6%, P = .225) between the AT with SAT group and the AT alone group. CONCLUSION: Children with nasal obstruction that undergo AT and SAT experience improvement in SN-5 scores. It remains uncertain whether SAT performed at the time of AT confers additional improvement in nasal symptoms compared to AT alone. Future research should include an assessment of SDB symptom burden to allow for a definitive determination of the role of turbinate surgery in children with SDB.

Adenotonsillectomy with turbinate ablation shows no added benefit for pediatric SDBSubmucosal ablation adds little benefit to adenotonsillectomy for children

Study Details

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Adenotonsillectomy with turbinate ablation shows no added benefit for pediatric SDBSubmucosal ablation adds little benefit to adenotonsillectomy for children

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