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Suctioning the Nasopharyngeal Airway01:29

Suctioning the Nasopharyngeal Airway

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Maxillary sinus involution after endoscopic sinus surgery in a child: a case report.

S B Levine1, S Mitra

  • 1Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.

American Journal of Rhinology
|March 11, 2000
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Functional endoscopic sinus surgery may impact pediatric facial bone growth, contrary to previous clinical reviews. This case report details significant maxillary sinus bone loss in a child after the procedure, highlighting potential iatrogenic risks.

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Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Medical Imaging

Background:

  • Functional endoscopic sinus surgery (FESS) is a common procedure for pediatric sinus conditions.
  • Previous studies on animal models suggested potential effects of FESS on facial skeletal growth.
  • Large clinical series reviews have generally not supported significant impacts on facial growth.

Observation:

  • A 12-year-old male underwent bilateral FESS.
  • Preoperative CT scans showed normal, symmetrical paranasal sinuses.
  • Postoperative CT scans revealed severe involution of the left maxillary sinus osseous skeleton.

Findings:

  • This case represents the first clinical report of facial skeleton alteration in a child post-FESS.
  • The observed changes are attributed to iatrogenic trauma to the osteomeatal complex.
  • Significant bone loss in the maxillary sinus was documented.

Implications:

  • Highlights a potential, previously underreported complication of FESS in pediatric patients.
  • Suggests careful consideration of surgical technique and potential risks in pediatric FESS.
  • Underscores the importance of detailed imaging follow-up after sinus surgery in children.