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[Sinusitis in the child. Evaluation and indication for surgical treatment]
Insights
Pediatric sinusitis often requires surgery when medical treatment fails. This study highlights the need for conservative sinus surgery in children, noting a 39% recovery rate but also a significant 31% loss to follow-up.
Area of Science:
- Pediatric Otorhinolaryngology
- Pediatric Surgery
- Medical Research
Background:
- Sinusitis is a common pediatric issue, frequently requiring surgical intervention due to incomplete medical management.
- Co-existing conditions such as tonsilloadenoiditis, rhinoseptal deformities, chronic otitis media, dental issues, and malnutrition were prevalent in pediatric sinusitis patients.
- Allergic rhinosinusitis was suspected in 50% and diagnosed in 15% of the pediatric cases.
Purpose of the Study:
- To evaluate the outcomes of surgical therapy for sinusitis in children.
- To identify the types of sinusitis and associated conditions in pediatric patients.
- To assess the effectiveness of surgical and complementary medical management for pediatric sinusitis.
Main Methods:
- A retrospective analysis of 51 pediatric patients (ages 2-16) who underwent sinus surgery between 1972-1975.
- Clinical diagnosis was supplemented by radiological and bacteriological studies.
- Surgical procedures included bilateral nasoantral windows (antrostomy) and unilateral Caldwell-Luc procedures, alongside other ENT surgeries.
Main Results:
- Chronic ethmoidal-maxillary and maxillary sinusitis were the most frequent diagnoses.
- Positive surgical findings were observed in 57% of the patients.
- The study reported a 39% recovery rate, with 31% of patients lost to follow-up post-surgery.
Conclusions:
- Conservative sinus surgery is a necessary approach for managing sinusitis in children.
- Incomplete medical treatment necessitates timely and appropriate surgical intervention.
- Further research is needed to address patient follow-up challenges and improve long-term outcomes.
Abstract:
Sinusitis in children is a frequent problem in pediatric otorhinolaryngology. Medical treatment is often incomplete or inadequate, creating the need for proper surgical therapy. In a 3 year period (1972-1975), at the E.N.T. Dept. of the "Hospital Infantil de México", a total of 51 patients, from 2 to 16 years age, underwent sinus surgery. The clinical diagnosis was completed with radiological and bacteriological studies. Chronic ethmoidal-maxillary and maxillary sinusitis were the most frequent types seen. Besides, considering E.N.T. sphere, other problems were present, mostly: tonsilloadenoiditis, important rhinoseptal deformity, and chronic otitis media. Also, dental caries, anemia, secondary to malnutrition and intestinal parasitosis, were additional frequent medical problems, among others. Allergic rhinosinusitis was suspected in at least 50% of them and clinically diagnosed in 15%. Bilateral nasoantral windows (antrostomy), and unilateral Caldwell-Luc procedure, were the surgical procedures most frequently performed. Adenoamygdalectomy, septorhinoplasty and mastoidectomy, were other frequent E.N.T. procedures. A total of 57% of the patients showed positive surgical findings at the time of sinus surgery; this is coincident with the work of other authors. Results of surgical and complementary medical management showed 39% of recovery rate. A high percentage of patients (31%), were lost to follow-up after initial surgery. The point of necessary conservative sinus surgery in children, is stressed in this paper.