Functional endoscopic sinus surgery in children: predictive factors of outcome

Abstract

The main objective of this study is to assess the results of functional endoscopic sinus surgery in children and to determine which factors independently influence the postoperative results. It is a prospective study by Mansoura University Hospital. 87 patients with different applications of pediatric endoscopic sinus surgery (PESS) chronic rhinosinusitis (CRS) with nasal allergy (45 patients), CRS without nasal allergy (36 patients) and CRS with polypsis (6 patients) from 2005 to 2010 were included. All children underwent endoscopic sinus surgery. All patients were clinically, radiologically and endoscopically monitored. In this study, the overall success rate was 87.69%, the success rate for CRS with nasal allergy was 87.5%, the success rate for CRS without nasal allergy was 85.7% and the success rate for CRS with polyposis was 93%. Regarding the patients' age, it could affect the surgical score value (X(2) = 9.446 and P* = 0.009). There was significant relation between type of the preoperative disease extent, adenoidectomy, second look operation and postoperative improvement. There was no significant relation between type of the preoperative disease or previous surgery and postoperative improvement. In conclusion, postoperative improvement was significantly correlated with extent of preoperative disease, adenoidectomy and second look operation and not significantly correlated with type of the preoperative disease or previous surgery. The results of PESS are influenced by age group, a younger age group is associated with more adhesions and recurrences and an older age group is associated with blood loss and higher surgical score. All these variables are contributing in the outcome of PESS.