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Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

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Pediatric chronic rhinosinusitis: when should we operate?

Mark D Rizzi¹, Ken Kazahaya

¹aDivision of Pediatric Otolaryngology, Children's Hospital of Philadelphia bDepartment of Otolaryngology - Head and Neck Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Current Opinion in Otolaryngology & Head and Neck Surgery

|December 5, 2013

Summary

Surgery for pediatric chronic rhinosinusitis (pCRS) is considered when medical therapy fails. Adenoidectomy is the first surgical step, with functional endoscopic sinus surgery (FESS) effective for persistent symptoms.

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Area of Science:

Otolaryngology
Pediatric Surgery
Rhinology

Background:

Pediatric chronic rhinosinusitis (pCRS) is a complex condition with multiple potential causes.
Multimodal medical therapy is the standard primary treatment for pCRS.
The exact timing and role of surgical interventions in pCRS management are not well-defined.

Purpose of the Study:

To review and summarize the existing literature on the timing and role of surgery in managing pediatric chronic rhinosinusitis (pCRS).

Main Methods:

Literature review of studies on surgical management of pCRS.
Analysis of current evidence regarding adenoidectomy and functional endoscopic sinus surgery (FESS) in children.
Evaluation of criteria for surgical intervention in pCRS.

Main Results:

Adenoidectomy is the recommended first-line surgical treatment for pCRS.
Antral lavage or balloon dilation may enhance outcomes when combined with adenoidectomy.
Functional endoscopic sinus surgery (FESS) is safe and effective for children with persistent pCRS symptoms unresponsive to maximal medical therapy.
Recent research primarily focuses on FESS outcomes rather than defining precise indications for its use.

Conclusions:

Surgical management of pCRS is an active area of research in otolaryngology.
Further prospective studies comparing surgical and nonsurgical treatments are needed to clarify indications for surgery in pCRS.
The role and timing of surgery in pCRS may vary depending on individual patient factors and underlying causes.