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Relation of age to outcome after endoscopic sinus surgery in children
1Department of Otolaryngology-Head and Neck Surgery, West Virginia University, PO Box 9200, Morgantown, WV 26506-9200, USA.
Insights
Endoscopic sinus surgery (ESS) shows better outcomes in children over six years old. Younger children, especially those under three, have lower success rates and higher revision surgery needs. ESS may still be beneficial for younger children with complications.
Area of Science:
- Pediatric Otolaryngology
- Surgical Outcomes Research
Background:
- Chronic sinusitis is a common condition in children.
- Endoscopic sinus surgery (ESS) is a treatment option for pediatric chronic sinusitis.
- The optimal age for ESS in children remains debated.
Purpose of the Study:
- To evaluate the age-specific outcomes of endoscopic sinus surgery (ESS) in children.
- To identify age groups that benefit most from ESS for chronic sinusitis.
Main Methods:
- A cohort study was conducted at a tertiary care children's hospital.
- Ninety-nine children undergoing ESS between 1994 and 1999 were analyzed.
- Outcomes were assessed via caregiver questionnaires at least one year post-surgery, defining success as symptom improvement and no need for revision surgery.
Main Results:
- The overall success rate for ESS was 82%.
- Children older than 6 years had an 89% success rate, compared to 73% for those younger than 6 years (P=.04).
- Revision surgery was required in 9% of patients, with a significantly higher rate in children younger than 6 years (P=.008), particularly those under 3 years (75% revision rate).
Conclusions:
- Endoscopic sinus surgery is less successful in children younger than 3 years.
- ESS demonstrates significant benefits for children older than 6 years.
- While ESS may be indicated for younger children with complications, a higher likelihood of revision surgery should be anticipated for those under 6 years.
Objective:
To determine whether endoscopic sinus surgery (ESS) in children has a better outcome at a certain age.
Design And Setting:
Cohort study in a tertiary care children's hospital.
Patients:
Ninety-nine children who underwent ESS between January 1994 and June 1999.
Main Outcome Measures:
Determining ESS outcomes was based on answers to a questionnaire mailed to the caregivers at least 1 year after surgery. Outcomes were considered failures if children required revision surgery or if their symptoms were not improved.
Results:
The overall ESS success rate was 82%. Univariate analysis of age and surgery outcome revealed that children older than 6 years had an 89% success rate but that children younger than 6 years had a 73% success rate (P =.04). Of the 99 patients, 11 (9%) required revision surgery. Among them, 9 were younger and 2 were older than 6 years (P =.008). Of the 4 children younger than 3 years, 3 (75%) required revision surgery.
Conclusions:
Endoscopic sinus surgery in children younger than 3 years was not successful but it was beneficial in children older than 6 years. It may be beneficial at any age if a complication from chronic sinusitis occurs; however, for children younger than 6 years, revision surgery may later be necessary.