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Complications of primary pediatric endoscopic sinus surgery for chronic rhinosinusitis: A 25-year single surgeon

Hassan H Ramadan1, Mustafa G Bulbul1, Fatima Asad2

  • 1Department of Otolaryngology West Virginia University Morgantown West Virginia USA.

Laryngoscope Investigative Otolaryngology
|June 23, 2022
PubMed

Insights

Complications from primary pediatric endoscopic sinus surgery (ESS) are rare, with orbital injuries being the most frequent. This study reviewed 352 children undergoing ESS, finding a low overall complication rate.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Rhinology

Background:

  • Chronic rhinosinusitis (CRS) in children often requires surgical intervention after medical and adenoidectomy failure.
  • Endoscopic sinus surgery (ESS) is a common treatment for pediatric CRS.
  • Understanding complication rates is crucial for informed surgical decision-making.

Purpose of the Study:

  • To document the incidence and types of complications associated with primary pediatric endoscopic sinus surgery (ESS).
  • To evaluate surgical outcomes in children undergoing ESS for chronic rhinosinusitis.

Main Methods:

  • A case series of 352 pediatric patients (<12 years) undergoing primary ESS between 1991 and 2016.
  • Inclusion criteria included failure of maximal medical therapy and/or adenoidectomy for CRS.
  • Complications reviewed encompassed skull base injury, CSF leak, orbital injuries, and significant bleeding.

Main Results:

  • The overall complication rate was 8.8% (31 of 352 patients).
  • No cases of blindness or orbital hematoma were reported.
  • The most common complications included lamina papyracea violation with orbital fat exposure (6.3%) and periorbital ecchymosis (1.4%).

Conclusions:

  • Primary pediatric ESS is associated with a low rate of severe complications.
  • Orbital injuries, particularly lamina papyracea violation, are the most frequent complications.
  • Surgeon experience and careful technique are vital in minimizing risks during pediatric ESS.
Abstract

Keywords:
adenoiditiscomplicationsendoscopic sinus surgerymaxillary antrostomypediatric CRS

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