[Sinusitis in the child. Evaluation and indication for surgical treatment]

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.