Endoscopic sinus surgery in pediatric chronic paranasal sinusitis

Objective: Chronic paranasal sinusitis is a relatively common clinical disorder in children. Endoscopic sinus surgery (ESS) is widely used to treat adults with chronic paranasal sinusitis. In this article, we present our experiences with endoscopic sinus surgery in children and discuss the efficacy after operation. Patients and Methods: From January 1993 through June 2000, 84 children with chronic paranasal sinusitis received endoscopic sinus surgery after failing to respond to optimal medical treatments. There were 45 boys and 39 girls included in this study. The children ranged in age from 3 to 16 years (average, 8.3) years. All of the children received endoscopic sinus surgery under general anesthesia. The post-operative sites were packed with Merocel and Surgicel. Endoscopic follow-up examinations were performed under ketamine anesthesia 2, 4 and 6 weeks after the operation, respectively. Each child was followed for more than 1 year. Results: Symptomatic improvement was assessed as being resolved, better, unchanged, and worse at 6 months after ESS. Significant improvement for each symptom was defined as the summation of those classified as resolved and better. The significant improvement rates in nasal obstruction and yellowish rhinorrhea were 89.1% and 87.6%, respectively. The most common complication was synechiae (16/84). No major complications were noted in the 84 children. Conclusion: FESS is considered appropriate for the treatment of pediatric sinusitis after optimal medical regimens have failed.