Long-term results of functional endoscopic sinus surgery in children with chronic rhinosinusitis with nasal polyps

M.E Cornet,W.J Fokkens,C Georgalas,S.M Reinartz

doi:10.4193/rhin13.079

Abstract

Chronic rhinosinusitis with nasal polyps (CRSwNP) is rare in children and has a major impact on Quality of Life (QoL). Functional endoscopic sinus surgery (FESS) has proven to be an effective treatment, but it is still unclear what long-term outcomes are in children with CRSwNP. The objective of this study was to assess long-term results of FESS in children with CRSwNP. We performed a combined prospective and retrospective study. A QoL questionnaire was send to all children with CRSwNP who received FESS between the year 2000-2010. Almost half of these children also filled in this questionnaire preoperatively. Forty-four Children underwent FESS. From 18 patients, we also prospectively collected preoperative QoL questionnaires. The mean follow-up period was 4.0 years (+- 2.9). The mean age at surgery was 13 years (+-2.9). Of these children, 9 had CF and 10 children asthma. R-SOM scores showed a significant improvement both in general symptoms as well as several different domains when comparing pre- and postoperative questionnaires. Only 5 of 44 patients needed a subsequent intervention. In children with CF this was 3 of 9. This study demonstrates that long-term results of FESS in children with CRSwNP are good. QoL has improved significantly, especially in nasal symptoms, showing that FESS is a good treatment in children with CRSwNP. Furthermore, even children with CF show good results.

Highlights

CRS with nasal polyps (CRSwNP) is rare in children and has a major impact on the Quality of Life (QoL) of paediatric patients and their parents [1]
This study demonstrates that long-term results of functional endoscopic sinus surgery (FESS) in children with CRSwNP are good
QoL has improved significantly, especially in nasal symptoms, showing that FESS is a good treatment in children with CRSwNP

Summary

Introduction

CRS with nasal polyps (CRSwNP) is rare in children and has a major impact on the Quality of Life (QoL) of paediatric patients and their parents [1]. 115 children were included and response rate was 64% (73/115) Of these 73 children with a mean age of 12 years, 39.1% had CRSwNP, 51.3% had CRSsNP, 5.2% had a maxillary cyst and 4.3% an antrochoanal polyp. They reported a 76% improvement at 5.4 years after FESS and several negative prognostic factors were found, including: cystic fibrosis, asthma, nasal polyps, allergies, previous surgery and smoking. The main objective of this study was to assess long-term results of FESS in children with CRSwNP with and without CF and to determine outcome, symptoms, quality of life and complications

Objectives

Results

Conclusion