Long-term Follow-up of Pediatric Chronic Rhinosinusitis After Surgical Treatment

Abstract

Objective: To study the long-term outcomes of pediatric chronic rhinosinusitis (CRS) after surgical treatment. Methods: Cross-sectional survey of patients who were treated surgically for CRS as children more than 10 years ago. Survey included SNOT-22 questionnaire, additional functional endoscopic sinus surgery (FESS) since last treatment, status of allergic rhinitis and asthma, and availability of any CT scan sinus/face for review. Results: About 332 patients were contacted by phone or email. Seventy-three patients filled the survey (22.5% response rate). Current age was 26 years (±+/−4.7, 15.3-37.8 years). Age at initial treatment was 6.8 years (+/−3.1, 1.7-14.7 years). Fifty-two patients (71.2%) had FESS and adenoidectomy, and 21 patients (28.8%) had adenoidectomy only. Follow-up since surgical treatment was 19.3 years (+/−4.1). SNOT-22 score was 34.5 (+/−22.2). None of the patients had any additional FESS for the duration of the follow-up, and only 3 patients had septoplasty and inferior turbinoplasty as adults. Twenty-four patients had CT scan sinuses/face available for review. Scans were obtained at an average of 14 years after surgical intervention (+/−5.2). CT LM score was 0.9 (+/−1.9), compared to 9.3 at time of their surgery (+/−5.9) ( P < .0001). Currently 45.8% and 36.9% of patients have asthma and AR, compared to 35.6% and 40.6% respectively as kids ( P = .897 and P = .167). Conclusion: Children who had surgery for CRS do not seem to have CRS as adults. However, patients continue to have active allergic rhinitis that may affect their quality of life.

Allergic Rhinitis as an Independent Risk Factor for Postoperative Recurrence of Children Chronic Sinusitis

“…Chronic rhinosinusitis (CRS) in children is an inflammatory disease that affects the mucosa of the nose and paranasal sinuses with a reported prevalence of about 4% in the pediatric population [1,2]. This prevalent disease often eludes diagnosis in otolaryngology departments, and its gradually increasing prevalence has attracted significant attention [3].…”

“…Similar to adult chronic rhinosinusitis, the clinical diagnosis and treatment of CRS in children has evolved from mainly relying on doctors' personal experience to being based on evidence-supported clinical guidelines. Accurate diagnostic and treatment strategies should be developed based on the etiology of CRS in children [1]. The clinical manifestations of pediatric CRS are nonspecific, including symptoms like nasal congestion, headaches, facial pain/pressure, cough, purulent nasal discharge and olfactory dysfunction, persisting for more than 12 weeks.…”

СОВРЕМЕННЫЕ АСПЕКТЫ ПАТОГЕНЕЗА ДЕТСКОГО РИНОСИНУСИТА: (Обзор Литературы)

“…Также стоит отметить, что гастроэзофагеальная рефлюксная болезнь может играть определенную роль в развитии ПЦД [23,24].…”