Functional endoscopic sinus surgery in treating pediatric chronic rhinosinusitis: The Aseer Region experience

Abstract

Objectives: This study aimed to investigate the clinical outcomes of functional endoscopic sinus surgery (FESS) in treating chronic rhinosinusitis (CRS) in Aseer Region children, and to look at the most likely etiologies that might be attributed to the need of surgical intervention in these children. Methods: Hospital charts for 47 children underwent FESS for CRS were retrospectively reviewed. We looked at the demographic information, clinical presentation, preoperative CT-scan reports and indications for the surgical procedure. Exclusion criteria include cases of FESS done by other surgeons, children below 4years and above 15 years, allergic fungal sinusitis, cystic fibrosis, mucocele and cases of antro-choanal polyps. Results: The majority of patients 38 (81%) presented with CRS were under the age of 8 years. The mean age was 6.5 years at presentation. There were 31 (66 %) males and 16 (34)% females. The persistent nasal discharge was the main symptom in 38 (81%) of the children. Eight (17%) children only presented with an associated nasal obstruction that was attributed directly to adenoid hypertrophy. Nineteen (40.4%) patients had obstructive anatomical variants and 28 (59.6%) patients were diagnosed having allergic rhinitis. Forty- one (87.2%) patient improved and required no further treatment and the remaining 6 (12.8%) patients required revision. Conclusions: Results of the present study are commensurate with findings from prior research in that they confirm that the FESS procedure is recommended to those who fail medical therapy and continue to have bothersome symptoms. Congenital anatomical obstruction (concha bullosa and Haller cells) followed by allergic rhinosinusitis havebeen found to be the most common etiological factors among the experimental group of children treated surgically.