An Overview of Surgical Approaches to Pediatric Chronic Sinusitis for Primary Care Providers

Ryan Sewell

doi:10.3390/sinusitis3020004

Abstract

Pediatric chronic rhinosinusitis is a common condition amongst pediatric patients. Despite its prevalence, debate continues regarding the best treatment strategies. The current paper examines the literature as it pertains to the surgical management of pediatric chronic rhinosinusitis. Adenoidectomy remains the mainstay in the initial surgical management. Both maxillary sinus irrigation and balloon dilation of the sinuses have been studied with disagreement as to the timing and patient selection for those procedures. Functional endoscopic sinus surgery is an accepted treatment modality, especially in initial surgical failures. Further studies will be needed to better delineate patient selection and timing of specific surgical techniques.

Highlights

Pediatric chronic rhinosinusitis (PCRS) is a common condition encountered in clinical practice
Multiple consensus statements are present in the literature, each providing a somewhat different recommendation on the best practices as it pertains to the treatment of PCRS [2,3,4]
These studies indicate that suction electrocautery remains the most cost-effective option with comparable to decreased risk profiles when compared to other techniques

Summary

Introduction

Pediatric chronic rhinosinusitis (PCRS) is a common condition encountered in clinical practice. Multiple consensus statements are present in the literature, each providing a somewhat different recommendation on the best practices as it pertains to the treatment of PCRS [2,3,4]. The ability of a child to cooperate with nasal endoscopy or CT can be beyond their developmental capabilities His or her ability to identify pain/pressure or nasal obstruction can be difficult. What constitutes maximal medical therapy, differs in the literature. It is beyond the scope of the current paper to further define maximal medical therapy It is beyond the scope of this paper to examine the treatment of pediatric patients with certain conditions, such as cystic fibrosis or ciliary dyskinesia, which will predispose them to PCRS.

Adenoidectomy

Maxillary Sinus Irrigation

Balloon Catheter Sinuplasty

Endoscpic Sinus Surgery

Findings

Conclusions