Abstract
Objective: 1) To validate a minimally invasive surgical approach including endoscopic fiberdiodelaser-assisted turbinoplasty, RFQ adenoidectomy, and sinus washes, as a first-line treatment for children with chronic nasal obstruction and noncomplicated recurrent sinusitis that failed at maximal medical treatment. Method: A prospective study of 50 children aged 3 to 13 years with persistent sinonasal symptoms was conducted in a tertiary private setting. Surgery under general anesthesia was done. The survey included NOSE instrument, child behavior, use of sinonasal medication and parent satisfaction at entry, 1, 6, and at least 24 months after surgery. Results: Significant improvement in NOSE score was observed 1 month after the procedure, and remains unchanged after 6 and 24 months of follow-up. Basal NOSE 92.5% ± 9.4 vs NOSE 1 month 7.2 % ± 12, NOSE 6 month 8.3 ± 15.2; 24 months 6.3 ± 10.3 (ANOVA P = .0001) .Patients used significantly less sinonasal medications. None remained with altered behavior ( P .001 McNemar’s test). Parent satisfaction was very high (Likert scale) with 95.8% at 6 months and 93% at 24 months. Conclusion: Laser-assisted turbinoplasty RFQ adenoidectomy and sinus washes are a successful approach for treating pediatric chronic nasal obstruction and sinusitis.
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