Functional endoscopic sinus surgery in children using a limited approach.

Area of Science:

• Otolaryngology
• Pediatric Surgery

Background:

• Chronic rhinosinusitis (CRS) is a common condition in children that is often refractory to medical treatment.
• Functional endoscopic sinus surgery (FESS) offers a surgical option for pediatric CRS.
• A limited surgical approach to FESS, focusing on drainage rather than extirpation, is utilized for refractory cases.

Purpose of the Study:

• To evaluate the efficacy of a limited FESS approach for pediatric CRS.
• To determine the indications for second-look endoscopy in pediatric CRS patients undergoing FESS.

Main Methods:

• Retrospective review of 101 pediatric patients with CRS treated with limited FESS.
• Assessment of symptom improvement via parental questionnaires at a mean follow-up of 27.2 months.
• Analysis of preoperative and postoperative symptoms including nasal obstruction, rhinorrhea, cough, and headache.

Main Results:

• High rates of symptom improvement were observed: nasal obstruction (91%), purulent rhinorrhea (90%), postnasal drip (90%), headache (97%), hyposmia (89%), and chronic cough (96%).
• Parental satisfaction with the surgery was high at 86%.
• Second-look endoscopy was performed in 28% of patients.

Conclusions:

• A limited FESS approach is effective for treating medically recalcitrant CRS in pediatric patients.
• Second-look endoscopy is indicated in specific cases to confirm disease removal and maintain sinus ostia patency.
• This study provides valuable data on FESS outcomes in a pediatric Asian population.