Pediatric functional endonasal sinus surgery: Review of 210 cases

Abstract

Functional endonasal sinus surgery (FESS) is an effective treatment for chronic or recurrent sinusitis in children, most of whom have failed more conservative medical treatment. The endoscopes used in FESS allow direct visualization of the diseased tissue and restoration of physiologic mucociliary clearance, enabling the sinus mucosa to return to its normal condition after the procedure. For a period of 3 to 36 months, we followed the recovery of 210 children who underwent FESS between 1986 and 1989. The age range of the children at the time of the procedure was 14 months to 16 years. Eighty percent of these patients had improvement of their sinusitis. There were no major complications. Eight percent of the 210 children needed revision surgery. Pediatric FESS is a two-stage operation requiring follow-up nasal cleaning under general anesthesia. The most common findings during the second-stage endoscopy were adhesions and granulation formation.

Pilot Study of Outcomes in Pediatric Rhinosinusitis

“…Participants: Consecutive 10-month sample of 41 children aged 2 to 13 years who met the following criteria: (1) roentgenographically documented sinusitis, (2) at least one 3-week course of a \g=b\-lactamase stable antibiotic, (3) 3 months or more of clinical symptoms or three or more annual recurrences, (4) Accepted for publication September 13, 1994. Presented …”

Functional Endoscopic Sinus Surgery in Children Using a Limited Approach

“…Nonetheless, in the study by Lazar et al, 15 nasal endoscopic examination and close postoperative follow-up were other prognostic factors. Stammberger stated that follow-up treatment of adult patients after FESS, consisting of cleaning crusted blood and eschar, is essential.…”

“…[17][18][19] Mitchell et al 17 reported no difference in clinical outcome in their study comparing 50 children who underwent SLE after FESS with 50 children who did not undergo SLE. Lazar et al 15 reported that of 210 patients who underwent FESS, postoperative nasal endoscopic examination showed significant adhesions between the middle turbinate and the septum in only 20% of the studied group. Ten percent of patients had granulation tissue formation, 7% had persistent polyposis, and 11% had significant crusting.…”

Do Adult Forms of Chronic Rhinosinusitis Exist in Children and Adolescents?

“…Other reports on the prevalence of nasal polyps in pediatric sinus surgery have ranged from 7% to 18.8% [33][34][35]. Tissue from pediatric nasal polyps might mimic an adult eosinophilic state or, less commonly, neutrophilia.…”