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Clinical Characteristics of Pediatric Chronic Rhinosinusitis: A Nationwide Retrospective Multicenter Study
Donghyeok Kim1, Gwanghui Ryu1, Sang Duk Hong1
1Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Insights
Functional endoscopic sinus surgery (FESS) improves pediatric chronic rhinosinusitis (CRS) symptoms and quality of life. Older age and less severe disease correlate with better outcomes after FESS for pediatric CRS.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Rhinology
Background:
- Pediatric chronic rhinosinusitis (CRS) significantly impacts children's quality of life and learning.
- Functional endoscopic sinus surgery (FESS) is a common treatment for CRS.
Purpose of the Study:
- To evaluate the postoperative outcomes in pediatric patients undergoing FESS for CRS.
- To identify factors associated with successful symptom control post-FESS.
Main Methods:
- Retrospective review of 213 pediatric patients (<20 years) with bilateral CRS undergoing FESS.
- Data included demographics, clinical history, CT scans, and symptom control.
- Statistical analysis using Kruskal-Wallis and Fisher exact tests.
Main Results:
- FESS significantly alleviated symptoms like nasal obstruction and rhinorrhea for up to 3 years (p<0.001).
- Overall, 56.8% of patients achieved controlled symptoms, 37.6% partly controlled, and 5.6% uncontrolled.
- Higher Lund-Mackay scores, longer follow-up, and revision surgery were linked to uncontrolled symptoms. Older age (≥16 years) correlated with better outcomes.
Conclusions:
- FESS is effective in improving postoperative symptoms and long-term quality of life for pediatric CRS patients.
- Older age and lower disease burden (lower Lund-Mackay scores) are associated with better symptom control after FESS.
Background And Objectives:
Pediatric chronic rhinosinusitis (CRS) significantly affects children's quality of life and learning abilities. This study aimed to evaluate the postoperative outcomes in pediatric patients who underwent functional endoscopic sinus surgery (FESS) for CRS.
Methods:
A retrospective review was conducted on pediatric patients who underwent FESS for CRS at 11 university hospitals. The inclusion criteria were patients under 20 years old with bilateral disease who were operated on between January 2005 and December 2021. The data collected included demographics, clinical history, blood tests, preoperative computed tomography, and preoperative and postoperative symptom control. The Kruskal-Wallis and Fisher exact tests were used to compare the quantitative and qualitative data, respectively.
Results:
In total, 213 patients were enrolled. The mean age was 13.4±3.0 years, and 145 (68.1%) were male. One hundred sixty-four patients (77.0%) had nasal polyps and 33 patients (15.5%) underwent revision FESS. The preoperative symptoms, in order of prevalence, included nasal obstruction (87.8%), rhinorrhea (71.8%), a sense of postnasal drip (58.2%), hyposmia (44.6%), cough (24.4%), and facial fullness (18.3%). These symptoms were significantly alleviated for up to 3 years after surgery (p<0.001). At the time of the last follow-up, 121 patients (56.8%) were controlled, 80 (37.6%) were partly controlled, and 12 (5.6%) were uncontrolled. Patients in the uncontrolled group had higher Lund-Mackay scores, longer follow-up durations, and more instances of revision surgery compared to those in the controlled and partly controlled groups. When age was categorized into three groups, those aged 16 years or older tended to have lower Lund-Mackay scores and better control.
Conclusion:
FESS significantly improves both the postoperative symptoms and the long-term quality of life in pediatric CRS patients. Better symptom control is associated with older age and a lower disease burden.
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