Age and indication for pediatric septoplasty in the NSQIP-P database.

[INTRODUCTION] Pediatric septoplasty has been a historically controversial topic in the field of otolaryngology. Past recommendations avoided reconstruction during development because of the potential for growth changes after intervention that may require later revision surgery. Recent studies have considered early operation to avoid further growth complications, pointing at changing trends in the field.

[METHODS] A retrospective study was conducted using the ACS NSQIP-P database to identify patients under 18 years of age who underwent a septoplasty between 2012 and 2019. Cases were identified using CPT code 30520 for 'septoplasty' and grouped by primary procedure as follows: cleft lip repair, sinus surgery, rhinoplasty/reconstruction/other, and septoplasty as primary procedure. Variables of interest included patient demographics, comorbidities, perioperative risk factors and complications.

[RESULTS] 2290 patients were included with a mean age of 14.2 years at time of surgery. Patients undergoing cleft lip repair were significantly younger than patients in the other procedure groups (mean age 9.3 years, p < .001), with 28% of the patients under 1 year of age. The most common comorbidity was congenital malformation (20.0%) followed by asthma (10.2%). Significantly longer total length of hospital stay was associated with younger age (p < .001), female gender (p = .007), and perioperative comorbidities (p < .001). 8 (0.3%) patients were readmitted within 30 days for reasons related to the primary septoplasty surgery and 15 patients (0.7%) had related reoperations within 30 days.

[CONCLUSION] Septoplasty is currently being performed on children of all ages. Children undergoing cleft lip repair account for the youngest demographic of pediatric septoplasty patients. General complications such as readmission and length of stay are more common in younger children undergoing septoplasty, however the number of readmissions and reoperations is relatively low. Further study is needed to describe the association between pediatric septoplasty and long term health outcomes.