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Published on: June 20, 2018
Pediatric endoscopic sinus surgery: Revisited 35 years later
Julian A Purrinos1, Ramzi Younis2
1University of Miami Miller School of Medicine, Rosenstiel Medical Science Building, Suite 1149, 1600 NW 10th Avenue, Miami, FL 33136, United States of America.
Insights
Pediatric endoscopic sinus surgery (PESS) has advanced significantly over 35 years, becoming a key treatment for pediatric sinus disorders. This review examines PESS evolution, focusing on improved outcomes and patient-centered care in pediatric otolaryngology.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Rhinology
Background:
- Pediatric endoscopic sinus surgery (PESS) has evolved over 35 years.
- Management of pediatric chronic rhinosinusitis (PCRS) has shifted towards comprehensive guidelines and refined surgical indications.
- PESS is now a cornerstone in treating pediatric sinus disorders.
Purpose of the Study:
- To review the evolution and impact of PESS in pediatric sinus disorder management.
- To highlight advancements in medical and surgical treatments for PCRS.
- To analyze changing practice patterns and outcomes of PESS.
Main Methods:
- Retrospective analysis of PESS utilization and outcomes.
- Review of recent literature on pediatric sinus disorder treatments.
- Examination of practice patterns, including adenoidectomy and selective PESS.
Main Results:
- PESS has become a refined intervention for pediatric sinus disorders.
- Advancements in diagnostics and less invasive procedures have influenced PESS application.
- Selective PESS is used for refractory cases, with emphasis on efficacy and symptom alleviation.
Conclusions:
- Ongoing innovation and research are crucial for refining PESS techniques.
- Collaborative efforts aim to expand treatment options for pediatric sinus disorders.
- The ultimate goal is to provide safe, effective, and patient-centered care, enhancing children's quality of life.
Abstract:
Over the past 35 years, pediatric endoscopic sinus surgery (PESS) has significantly evolved from its inception as a novel intervention to become a cornerstone in the management of pediatric sinus disorders. This evolution is reflective of a broader shift towards a more nuanced understanding and treatment of pediatric chronic rhinosinusitis (PCRS), marked by the introduction of comprehensive guidelines and the refinement of surgical indications. Recent literature and the extensive experience of the senior author, who has been at the forefront of utilizing PESS since its inception, highlight a noticeable shift in the procedure's utilization. This paper reviews the journey of PESS, highlighting the impact of advancements in medical treatment modalities, such as improved diagnostic techniques and the adoption of less invasive procedures. The development and optimization of PESS are discussed in the context of changing practice patterns, including the prevalent use of adenoidectomy and the selective application of PESS for refractory cases. An emphasis is placed on the outcomes associated with different surgical interventions for PCRS, highlighting their efficacy in alleviating symptoms and managing underlying conditions. The paper concludes by emphasizing the importance of ongoing innovation and collaborative research in further refining surgical techniques and expanding treatment options, with the ultimate goal of delivering safe, effective, and patient-centered care to children with sinus-related disorders. This retrospective analysis demonstrates a commitment to enhancing the quality of life for pediatric patients, reflecting the substantial progress achieved in the field of pediatric otolaryngology over the last three decades.
