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Management of chronic rhinosinusitis
Alessandro Cazzavillan1, Paolo Castelnuovo, Marco Berlucchi
1Pediatric ENT Department, Buzzi Children's Hospital, Istituti Clinici di Perfezionamento, Via Castelvetro 32, Milan, Italy. a.cazzavillan@icp.mi.it
Summary
Treating chronic rhinosinusitis (CRS) in children presents challenges. New techniques like balloon sinuplasty and functional endoscopic sinus surgery show promise, alongside the importance of patient-reported outcomes (PROs) for assessing treatment effectiveness.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Medical Technology
Background:
- Chronic rhinosinusitis (CRS) in children is a complex condition with frequent treatment failures and recurrences.
- Current medical treatments including antibiotics, nasal corticosteroids, and saline lavage lack universal agreement on efficacy.
- The exact etiology of pediatric CRS remains debated, complicating treatment strategies.
Purpose of the Study:
- To review current treatment modalities for chronic rhinosinusitis in children.
- To evaluate the efficacy and role of emerging techniques such as balloon sinuplasty and functional endoscopic sinus surgery.
- To highlight the significance of patient-reported outcomes (PROs) in assessing treatment effectiveness for pediatric CRS.
Main Methods:
- Review of existing literature on pediatric chronic rhinosinusitis treatments.
- Analysis of outcomes for medical therapies, adenoidectomy, balloon sinuplasty, and functional endoscopic sinus surgery.
- Discussion on the integration and importance of patient-reported outcomes (PROs) and health-related quality of life (HRQL) measures.
Main Results:
- Balloon sinuplasty demonstrates promising initial outcomes for restoring sinus ventilation with minimal trauma.
- Functional endoscopic sinus surgery offers a minimally invasive approach to restore sinus ostia patency and natural drainage.
- Adenoidectomy alone has controversial therapeutic effects for CRS, with studies failing to prove its sole sufficiency.
- Patient-reported outcomes (PROs), including health-related quality of life (HRQL), are crucial for a comprehensive evaluation of treatment effectiveness.
Conclusions:
- Pediatric CRS management requires a multifaceted approach, considering both procedural interventions and patient-centered assessments.
- Minimally invasive surgical techniques like balloon sinuplasty and functional endoscopic sinus surgery represent advancements in treating pediatric CRS.
- Incorporating patient-reported outcomes (PROs) is essential for a complete understanding of treatment success and impact on children's well-being.
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