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Timing of Endoscopic Sinus Surgery in Children: Is There an Impact on Outcome?
Author(s) -
Ramadan Hassan H.
Publication year - 2001
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200110000-00007
Subject(s) - medicine , surgery , prospective cohort study , sinusitis , logistic regression , endoscopic sinus surgery , chronic sinusitis , sinus (botany) , endoscopy , botany , biology , genus
Objectives/Hypothesis Endoscopic sinus surgery in children continues to be a controversial issue. Major factors in determining when to operate are the duration of the disease and duration of medical treatment. Study Design Prospective study of children referred to a tertiary center. Patients and Methods Eighty‐three patients underwent endoscopic sinus surgery for refractory chronic sinusitis. All patients were followed prospectively to evaluate their response to surgery for a mean follow‐up period of at least 1 year. A χ 2 analysis and logistic regression analysis were performed to determine statistical difference between duration of symptoms and outcome. Results The overall success rate of endoscopic sinus surgery was 80%. Children who had surgery between 6 and 12 months of symptoms despite continued medical therapy had an 84% success rate, those who had surgery between 12 and 18 months had a 74% success rate, and those with more than 18 months of treatment for symptoms had an 81% success rate ( P >.05). Conclusions Duration of the symptoms of chronic sinusitis in children of more than 6 months was not a predictor of success of endoscopic sinus surgery in these children. Although there seemed to be a trend toward having a more successful procedure in children who had surgery between 6 and 12 months of medical treatment versus those who had surgery after more than 12 months of medical treatment, this did not reach statistical significance. A prospective study with more patients may shed more light on this subject.