Abstract
In children with chronic rhinosinusitis (CRS) refractory to medical therapy, both adenoidectomy and endoscopic sinus surgery (ESS) are considered to be surgical options. This review presents the current literature regarding the role of ESS in management of CRS in the pediatric population. Adenoidectomy has a success rate of 40–69% with a complication rate of 3.2%. Similarly, ESS has a reported success rate of 71–100% with a complication rate of 0.6–3%. ESS does not appear to have long-term adverse effects on facial growth based on recent longitudinal human studies. Age appears to be a factor in the efficacy of endoscopic sinus surgery. Patients older than 6 years have been shown to have better success rates for both ESS and adenoidectomy than those under six. In addition, ESS may be more effective than adenoidectomy in children older than 6 years. However, in children younger than 6 years, the difference in success rates has not been found to be statistically significant between the two procedures. ESS is an effective surgical treatment for pediatric patients with CRS and is best performed when medical therapy, adenoidectomy, or both have failed.
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