The Effect of Long-Term Follow up on Outcome of Pediatric Endoscopic Sinus Surgery

BACKGROUND AND OBJECTIVES: Chronic pediatric sinusitis continues to be a challenging problem to otolaryngologists and has been reported to show worse prognosis than that of adults. However, most studies were performed with short-term follow-up. In this study, we aimed to assess the clinical outcome of pediatric endoscopic sinus surgery (ESS) with a longer follow-up and to determine the effect of age on postoperative outcome. SUBJECTS AND METHOD: A retrospective analysis was performed on pediatric patients than 15 years with ESS younger from 2005 to 2014 in a tertiary referral hospital. All patients completed a questionnaire regarding symptoms before to from 1 to 9 years after surgery. Telephone survey was performed to evaluate symptoms including nasal obstruction, nasal discharge, PND, and headache at 1 to 9 years after surgery. RESULTS: Seventy-one pediatric patients with bilateral chronic sinusitis were treated with ESS. They showed gradual symptom improvement from 5 year after surgery for the following: nasal obstruction (p=0.032), PND (p=0.005), and headache (p=0.048). However, there was improvement in rhinorrhea after 9 years (p=0.042). In addition, when analyzed in terms of age, the outcome was poor in children younger than 13 years (p=0.003) compared with the older age group. Multivariate analysis showed that preoperative nasal obstruction was dependent on AR, and postoperative symptoms were dependent on presence of AR and involuntary smoking. Nasal discharge was dependent on presence of AR and involuntary smoking preoperatively and postoperatively. These suggest the importance of AR and involuntary smoking as risk factors for prognosis. CONCLUSION: Chronic pediatric sinusitis showed gradual improvement after ESS and should be more carefully monitored on a long-term basis. We should keep in mind that long-term follow-up is needed for pediatric ESS cases.

The efficacy of nasal irrigation for pediatric chronic sinusitis / 中国基层医药

Objective To explore the clinical efficacy of nasal irrigation for pediatric chronic sinusitis. Methods 92 children with chronic sinusitis were selected and randomly divided into treatment group(48 cases) and control group(44 cases) .The two groups were treated with routine clinical basic drugs,and the treatment group took nasal irrigation in addition.The efficacy after 1 month was compared, and then the patients were followed up for 3 months.Results The total effective rate of the treatment group was 91.7% after 1 month,which of the control group was 72.7%.After 3 months,the total effective rate in treatment group was 95.9%,which of the control group was 86.4%.There were statistically significant differences between the two groups in treatment outcomes( P=0.024, 0.011) .Conclusion The therapeutic effect of nasal irrigation for pediatric chronic sinusitis is obvious, safe and reliable.

Efficacy of Bikang Tablets Combined with Amoxicillin and Sulbactam Tablets for Pediatric Chronic Sinusitis / 中国药房

OBJECTIVE: To evaluate the clinical efficacy of Bikang tablets combined with amoxicillin and sulbactam tablets for pediatric chronic sinusitis.METHODS: The children with pediatric chronic sinusitis were randomized to two groups of 180 each: the treatment group received Bikang tablets combined with amoxicillin and sulbactam tablets while the control group received amoxicillin and sulbactam tablets alone for 30 days(3 courses).RESULTS: The clinical efficacy in the treatment group was significantly higher than in the control group(P

Anatomic Variations of the Paranasal Sinus in Children with Chronic Sinusitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery in children has increased in the recent years. Therefore, we need to know the precise anatomy and anatomic variations of the nose, and we also need to know the relationship between these anatomic variations and sinusitis. SUBJECTS AND METHOD: To assess the extent and distribution of diseases as well as associated anatomic abnormalities in this pediatric population, we retrospectively reviewed 94 OMU CT scans of children who showed continued symptoms of sinusitis after extensive medical therapy had failed. RESULTS: Maxillary sinusitis was the most common sinus infection, followed by ethmoidal, sphenoidal and frontal sinusitis. A agger nasi cell was the most common anatomic variation, followed by septal deviation, Haller's cell, concha bullosa, paradoxical middle turbinate and Onodi's cell. There was no statistical significance between the sinusitis and anatomic variations. CONCLUSION: Anatomic variations in the nose are common in children. However, because there is no definitive relationship between the anatomic variations and sinus disease, local, systemic or environmental factors appear to be more important in pediatric sinusitis than anatomic variations.