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Our experience with FESS in children
R Risavi1, I Klapan, J Handzić-Cuk
1Department of Otorhinolaryngology, Medical Faculty, Zagreb, Croatia. kim@sirius.phy.ht
Insights
This study evaluated surgical outcomes in 50 children for various pediatric rhinosinusitis conditions. Post-operative complications like synechiae and recurrent polyposis occurred in a subset of patients with nasal polyposis.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Rhinosinusitis Research
Background:
- Pediatric rhinosinusitis encompasses diverse conditions requiring surgical intervention.
- Indications include complications of acute rhinosinusitis, foreign bodies, polyps, and chronic rhinosinusitis.
Purpose of the Study:
- To analyze surgical outcomes in children treated for various sinonasal conditions.
- To identify the incidence of post-operative complications in specific pediatric patient groups.
Main Methods:
- A cohort of 50 children (ages 7-15) underwent surgery for rhinosinusitis-related conditions between 1993-1996.
- Preoperative treatment included CT imaging, corticosteroids, Fluticasone Propionate, and antibiotics.
- Surgical procedures were performed under endotracheal anesthesia with induced hypotension.
Main Results:
- Among 15 patients with nasal polyposis or antrochoanal polyps, complications included synechiae (4 cases), recurrent polyposis (2 cases), and recurrent antrochoanal polyps (2 cases).
- Specific complication rates for other indications (periorbitis, foreign bodies, cystic fibrosis-related polyposis, chronic rhinosinusitis) were not detailed in the abstract.
Conclusions:
- Surgical intervention for pediatric sinonasal conditions carries a risk of post-operative complications, particularly in cases of nasal polyposis.
- Further research is needed to optimize surgical techniques and management strategies for pediatric rhinosinusitis.
Abstract:
Between 1993 and 1996 we operated on 50 children with one of the following surgical indications: 17 children with a complication of acute rhinosinusitis and the propagation of the process towards the orbit (periorbitis), six children with an ethmoid and sphenoid foreign body (shrapnels shells), 11 children with an antrochoanal polyp, four children with nasal polyposis in cystic fibrosis and 12 children with chronic rhinosinusitis after 2-4 acute reinfections. The surgery was done under endotracheal anesthesia with hypotension. CT axial and coronal tomograms were done during the preoperative treatment. During the 2 weeks preoperative treatment, the patients with polyposis and antrochoanal polyps were treated with 4-8 mg of cortisone per os or i.m., and also with Fluticasone Propionate 100 mg twice a day and antibiotics in chronic and acute rhinosinusitis. The children's age was between 7 and 15 years. In the patients with nasal polyposis and antrochoanal polyps (n = 15) post-operatively, we had four cases of synechiae, recurrent polyposis in two and antrochoanal polyps in two cases.