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Published on: June 20, 2018
Efficacy of endoscopic sinus surgery in patients under six years old
Harrington Chloe1, Ibrahim Ibrahim1, Hengameh Bezadpour1
1Division of Otolaryngology-Head & Neck Surgery, Children's National Medical Center, Washington, D.C, USA.
Insights
Endoscopic sinus surgery (ESS) is safe for children under six with acute or chronic rhinosinusitis, showing minimal complications and no deaths in this young patient group. Further research is recommended for long-term outcomes.
Area of Science:
- Pediatric Otolaryngology
- Rhinology
- Surgical Innovation
Background:
- Endoscopic sinus surgery (ESS) is increasingly utilized in pediatric otolaryngology.
- Data on the safety and efficacy of ESS in very young children (under six) is limited.
- Indications for ESS in this age group often include complicated acute rhinosinusitis (ARS) or chronic rhinosinusitis (CRS).
Purpose of the Study:
- To evaluate the safety and efficacy of ESS in pediatric patients under the age of six.
- To analyze outcomes for very young patients undergoing ESS for ARS or CRS.
Main Methods:
- Retrospective cohort review of patients under six years old who underwent ESS between 2016 and 2023.
- Data collected included patient demographics, diagnosis, surgical details, and outcomes.
- Level 4 evidence was utilized.
Main Results:
- Twenty-five patients (1 month to 5 years) met inclusion criteria.
- Eighteen patients had complicated ARS, and 7 had CRS.
- Five patients required revision surgery; only one surgical complication was observed, with no mortalities.
Conclusions:
- ESS appears safe for very young pediatric patients (under six) with sinonasal pathology.
- The study observed a low rate of morbidity and no mortality in this cohort.
- Further investigation into long-term outcomes is warranted, but ESS can be considered safe for acute conditions.
Objectives:
To examine safety and efficacy of very young patients under the age of six who underwent endoscopic sinus surgery (ESS) at our institution for the indications of either complicated acute rhinosinusitis (ARS) or chronic rhinosinusitis (CRS).
Methods:
Retrospective cohort review of patients under six years old who underwent ESS for sinonasal pathology between 2016 and 2023 at a freestanding pediatric hospital. Age, sex, weight, diagnosis, laterality of disease, medications, types and number of surgical interventions, usage of image guidance, and outcomes were obtained from the medical record.
Results:
A total of 25 patients met inclusion criteria (range 1 month-5 years). Eighteen of the patients underwent surgery for an indication of complicated ARS and 7 patients underwent surgery for CRS. Ages were separated into three categories, <1 year (n = 1), 1-3 year (n = 3), 3-6 year (n = 21). Chi squared testing between these three age groups revealed no significant differences in revision rates. There were 5 children who required revision surgery, 3 of which had CRS. Ages of the children who required revision ranged from 2 to 4 years old. There was only one surgical complication observed.
Conclusions:
Endoscopic sinus surgery has been increasingly considered safe in pediatric otolaryngology, however, our database in particular focuses on a very young subset of these patients in which there were very few (one) morbidities and no mortalities. Further study of this population should be continued to determine long term outcomes; however, it should be considered safe in acute situations.
Level Of Evidence:
Level 4.
