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Smoke exposure and outcome of endoscopic sinus surgery in children
Hassan H Ramadan1, Raymond A Hinerman
1Department of Otolaryngology-Head and Neck Surgery, West Virginia University, PO Box 9200, Morgantown, WV 26506-9200, USA.
Objective:
The study goal was to determine whether cigarette smoke exposure in children who are undergoing endoscopic sinus surgery (ESS) for chronic sinusitis will have an impact on the outcome.
Design:
We conducted a cohort study in a tertiary care children's hospital setting.
Patients And Methods:
The study population consisted of 118 patients who underwent ESS between January 1994 and June 1999. The mean age was 6.5 (range, 2 to 13 years). The outcome of ESS was measured > or =1 year after the operation. A questionnaire was mailed to the caretakers to measure success. Those who required revision subsequently were considered as failures.
Results:
Multivariate logistic regression analysis was performed with smoke exposure as an independent variable and outcome measured as success of procedure. The overall success rate was 83%. Univariate analysis of smoke exposure and outcome of surgery revealed that children exposed to smoke in household had a 70% success rate compared with children not exposed to smoke, who had a 90% success rate (P = 0.007). Multivariate analysis revealed smoke exposure continued to be an independent predictor of success.
Conclusion:
ESS in children with cigarette smoke exposure predisposes to a poorer outcome. This needs to be taken into consideration when recommending ESS for those children.