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Quality of life after endoscopic sinus surgery in refractory pediatric chronic rhinosinusitis
Gyanesh Sethi1, Arunabha Chakravarti1
1Department of ENT and Head & Neck Surgery, Lady Hardinge Medical College and Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi, 110001, India.
Insights
Endoscopic Sinus Surgery (ESS) significantly improved symptoms and quality of life in children with refractory Chronic Rhinosinusitis (CRS). The procedure proved safe and effective for pediatric patients unresponsive to medical treatments.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Medical Research
Background:
- Pediatric Chronic Rhinosinusitis (CRS) often presents challenges in management.
- Refractory CRS cases require evaluation for advanced treatment options.
- Maximal medical therapy may not be effective for all pediatric CRS patients.
Purpose of the Study:
- To assess the efficacy of Endoscopic Sinus Surgery (ESS) for pediatric CRS.
- To evaluate the impact of ESS on the quality of life in children with CRS.
- To determine the safety profile of ESS in this patient population.
Main Methods:
- Prospective interventional study of 35 children (6-12 years) with refractory CRS.
- Patients received ESS after failing 4 weeks of maximal medical therapy.
- Symptom severity and quality of life (SN-5 score) were assessed preoperatively and 1 year post-surgery.
Main Results:
- 91.4% of children experienced improved symptom scores post-ESS (p < 0.001).
- Quality of life significantly improved in 91.4% of patients (p < 0.001).
- No major complications were reported during the study period.
Conclusions:
- Endoscopic Sinus Surgery is a safe and effective treatment for pediatric CRS.
- ESS leads to significant symptom reduction and improved quality of life.
- Surgical intervention should be considered for children with refractory CRS.
Objective:
The present study aims to evaluate the role of Endoscopic Sinus Surgery (ESS) in refractory pediatric Chronic Rhinosinusitis (CRS) and to assess the change in quality of life after ESS.
Materials And Methods:
This prospective interventional study included 35 children (aged between 6 and 12 years) of refractory CRS, not responding to 4 weeks of maximal medical therapy attending the pediatric ENT clinic of a tertiary referral centre. Study period was from November 2013 to March 2016. This patient pool underwent Non Contrast Computed Tomography scan (NCCT) paranasal sinuses and diagnostic nasal endoscopy and those fulfilling the requisite inclusion criteria underwent Endoscopic sinus surgery. Global assessment of Rhinosinusitis Symptom severity score and SN-5 quality of life score of the patients was assessed preoperatively and 1 year after the surgery.
Results:
91.4% children showed an improvement in the total symptom score with a statistically significant (p value < 0.001) reduction in the mean total score postoperatively. Similarly 91.4% of the children showed an improvement in their quality of life with a statistically significant (p value < 0.001) difference seen in the average SN-5 scores after ESS. No major complications were encountered in any of the cases.
Conclusion:
ESS is a safe and effective surgical management for children with CRS refractory to maximal medical therapy leading to an improvement in their quality of life.
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