The role of sinus surgery in children

Objectives/Hypothesis To critically review the current literature discussing the outcome of endoscopic sinus surgery (ESS) in children with chronic rhinosinusitis (CRS). Study Design Literature review. Methods PubMed database and the Cochrane Library were searched. The PubMed search included all English-language literature published between January 1990 and July 2012 discussing the role of ESS in children with CRS. Studies that included patients with cystic fibrosis, primary immunodeficiency disorders, or ciliary dysmotility disorders were excluded. Results Of the 507 articles retrieved from the primary research strategy, 11 studies were included for further discussion. There were no randomized controlled studies. The rate of success of pediatric ESS ranged from 82% to 100% in selected patients. Children undergoing ESS for CRS usually have more severe disease compared to those who get medical treatment or adenoidectomy. The extracted rate of complication was 1.4%, with no cases of cerebrospinal fluid leak or major orbital injury such as hematoma or blindness reported. Conclusions ESS offers a surgical alternative in the treatment of CRS in children with an excellent safety profile. There remains a need for higher level studies addressing the indications of ESS in children.