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Pediatric endoscopic sinus surgery: postoperative management

Mary Catherine Brown1, Adva Buzi1,2, Mark D Rizzi1,2

  • 1Division of Otolaryngology, Children's Hospital of Philadelphia.

Current Opinion in Otolaryngology & Head and Neck Surgery
|September 29, 2025
PubMed

Insights

Postoperative care for pediatric chronic rhinosinusitis after endoscopic sinus surgery primarily involves nasal saline rinses and steroid sprays. Further research is needed for other interventions like antibiotics and systemic steroids.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Rhinology

Background:

  • Chronic rhinosinusitis (CRS) affects pediatric patients, often requiring medical management.
  • Endoscopic sinus surgery (ESS) is indicated for refractory pediatric CRS.
  • Optimal postoperative care guidelines for pediatric ESS are not well-established.

Purpose of the Study:

  • To review and elucidate best practices for postoperative care in pediatric patients undergoing ESS.
  • To identify evidence-based recommendations for managing patients after ESS for CRS.

Main Methods:

  • Literature review of existing studies and guidelines.
  • Analysis of recommendations for postoperative care in pediatric ESS.
  • Extrapolation of data from adult studies and older literature.

Main Results:

  • Limited data exists specifically for pediatric ESS postoperative care.
  • Nasal saline rinses and topical nasal steroid sprays are foundational treatments.
  • Steroid-impregnated saline has limited pediatric data; routine antibiotics and second-look endoscopy are generally not recommended but may be considered case-by-case.

Conclusions:

  • Saline irrigation and topical steroid sprays are safe and effective for healing and preventing symptom recurrence post-ESS.
  • Further research is required to clarify the roles of systemic steroids, antibiotics, and debridement in pediatric ESS.
  • Evidence-based guidelines for pediatric ESS postoperative care need further development.
Abstract

Keywords:
chronic rhinosinusitisnasal saline rinsespostoperative nasal endoscopytopical nasal steroids

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