Related Experiment Videos
Functional endoscopic sinus surgery: results in the young child
1Mississippi Asthma and Allergy Clinic, Jackson, USA.
Insights
Functional endoscopic sinus surgery (FESS) is effective for young children with chronic sinusitis unresponsive to medical treatment. This study shows FESS offers significant symptom improvement and reduces medication needs in pediatric patients.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Rhinosinusitis Research
Background:
- Limited data exists on long-term outcomes of functional endoscopic sinus surgery (FESS) in young children.
- Chronic rhinosinusitis in pediatric patients often requires surgical intervention after medical management failure.
Purpose of the Study:
- To evaluate the long-term effectiveness and safety of FESS in children aged six years or younger.
- To assess the impact of FESS on symptom reduction and need for further medical treatment in pediatric sinusitis.
Main Methods:
- A cohort of 57 children (age ≤6 years) underwent FESS by a single surgeon after failing medical therapy.
- Preoperative coronal sinus CT scans evaluated sinus opacification and ostiomeatal complex obstruction.
- Parental questionnaires assessed outcomes 5–36 months post-surgery.
Main Results:
- Ninety-three percent of children experienced improvement as reported by parents.
- Improvement was characterized by reduced symptoms, decreased antibiotic use, and fewer physician visits.
- No major surgical or anesthetic complications were reported during the study period.
Conclusions:
- Functional endoscopic sinus surgery (FESS) is a safe and effective treatment for chronic sinusitis in young children who have not responded to aggressive medical management.
- FESS provides significant symptom relief and reduces the need for ongoing medical interventions in pediatric patients.
Abstract:
Recent studies have addressed the usefulness of functional endoscopic sinus surgery (FESS) in both adult and pediatric patients, but little information is available concerning the long-term followup of young children. During a 31 month period, 57 children, age six years or less had FESS performed by a single surgeon. In each case the child had failed aggressive medical management including long-term oral antibiotics. A coronal sinus CT scan was obtained prior to surgery and showed opacification of the maxillary and/or ethmoid sinuses with obstruction of the ostiomeatal complexes. A similar surgical approach was used in each case. There were no major surgical or anesthetic complications noted during the initial procedure or the followup debridement. To evaluate the results of FESS, a questionnaire was mailed to the parents of each patient. The questionnaires were completed 5 to 36 months after surgery (mean 17.3 months). Ninety-three percent of the children showed improvement based on the observations of their parents. Improvement was judged primarily by reduced symptoms, reduced need for antibiotics, and the need for fewer doctor visits during the followup period. In summary, FESS appears to offer a safe and effective technique to control sinus disease in children who do not respond to aggressive medical management. In skilled hands, this technique is associated with few complications and appears to offer relief even in young patients.