The endoscopic endonasal surgical technique in the treatment of chronic recurring sinusitis in children
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G Wolf1, K Greistorfer, J A Jebeles
1Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital, Graz, Austria.
Insights
Endoscopic endonasal sinus surgery is a safe and effective treatment for pediatric chronic recurring sinusitis (CRS) when medical management fails. This technique shows successful outcomes and high patient satisfaction without impacting facial growth.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Rhinosinusitis Research
Background:
- Pediatric chronic recurring sinusitis (CRS) presents diagnostic and therapeutic challenges due to immature sinus and immune systems.
- Potential risks include altered development of paranasal sinuses and maxillary tooth buds from surgical interventions.
- Previous surgical methods for refractory CRS in children have varying outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of endoscopic endonasal sinus surgery in pediatric patients with CRS.
- To assess patient satisfaction and symptomatic relief following the procedure.
- To investigate potential complications and effects on facial growth and development.
Main Methods:
- A retrospective review of 124 pediatric patients with CRS undergoing endoscopic endonasal sinus surgery.
- Utilized the Messerklinger and Stammberger surgical technique over an 11-year period.
- Assessed outcomes via a detailed questionnaire on patient satisfaction and symptom relief.
Main Results:
- The endoscopic endonasal technique demonstrated successful outcomes in treating pediatric CRS.
- High levels of patient satisfaction and symptomatic relief were reported.
- No complications such as CSF leak or orbital injury were observed; no adverse effects on facial growth were noted.
Conclusions:
- Endoscopic endonasal sinus surgery is a safe and effective treatment option for pediatric CRS refractory to medical management.
- The Messerklinger and Stammberger technique offers a favorable risk-benefit profile for children.
- This approach supports normal facial growth and development while resolving chronic sinusitis symptoms.
Abstract:
Chronic recurring sinusitis (CRS) is a difficult diagnosis to make in the paediatric patient. However, increased awareness by physicians and improved technology are contributing to an increasing frequency of this diagnosis. Children with their immature development of the paranasal sinuses and immunological systems present special problems in the treatment of CRS. Concern must be given to potential alteration of the development of the paranasal sinus system and tooth buds in the maxilla by a surgical procedure in children. Various surgical procedures have been recommended in the past in the treatment of CRS failing medical management. A review of 124 paediatric patients undergoing endoscopic endonasal sinus surgery using the technique of Messerklinger and Stammberger in the treatment of CRS over an 11-year period is presented. A detailed questionnaire regarding patient's satisfaction and symptomatic relief has been sent to all patients. The results indicate a successful outcome from this technique and a high level of patient satisfaction. No complications such as CSF leak or orbital injury have been encountered, and no evidence of altered facial growth and development has been noted. We find the endoscopic endonasal technique to be a safe and effective method in the treatment of children with CRS failing medical management.