Surgical management of chronic sinusitis in children

Laryngoscope. 2004 Dec;114(12):2103-9. doi: 10.1097/01.mlg.0000149441.28231.0c.

Abstract

Objectives/hypothesis: The objective was to compare three common surgical modalities in children for the treatment of chronic sinusitis that is refractory to medical management.

Study design: Prospective nonrandomized study in a pediatric otolaryngology tertiary service.

Methods: Two hundred two children who satisfied criteria for surgery and were referred over a 10-year period were studied. Children were divided into three surgical groups. Group 1 had both endoscopic sinus surgery and adenoidectomy, group 2 had endoscopic sinus surgery alone, and group 3 had adenoidectomy. After a follow-up period of 12 months, improvement of symptoms was assessed.

Results: One hundred eighty-three children had adequate follow-up. Eighty seven percent of children in group 1 had improved symptoms, compared with 75% in group 2 and 52% in group 3 (P < .0001). Multivariate analysis showed that surgical procedure was a predictor of success. Asthma, smoke exposure, and age were independent predictors of success.

Conclusion: Children who fail medical therapy benefit from surgery. Following certain criteria, one can chose between adenoidectomy alone or endoscopic sinus surgery with adenoidectomy to optimize surgical treatment of these children.

Publication types

  • Comparative Study

MeSH terms

  • Adenoidectomy / methods*
  • Adolescent
  • Age Factors
  • Analysis of Variance
  • Child
  • Child, Preschool
  • Chronic Disease
  • Cohort Studies
  • Combined Modality Therapy
  • Endoscopy / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Multivariate Analysis
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Patient Selection
  • Probability
  • Prospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Sex Factors
  • Sinusitis / diagnosis*
  • Sinusitis / surgery*
  • Treatment Outcome