Radical Endoscopic Antrum Surgery for the Treatment of Pediatric Sinusitis

Kim, Yong Jae; Lee, Sang Hoon

Abstract

BACKGROUND: The follow-up results of traditional surgical methods have yielded less positive results with children than they have with adults. The maxillary sinuses are commonly affected by residual mucosal diseases, so an endoscopic nasal examination frequently reveals recurrent polyposis. Irreversibly diseased maxillary sinus mucosa exhibiting polyposis and thickening can easily be accessed and extirpated endoscopically. The endoscopic approach of examining the maxillary sinuses is also the easier route when treating younger children.
Subjects and Methods
Under study were eight cases of rhinosinusitis in children aged between three and fifteen years old. The patients had been unresponsive to medical treatment with antibiotics for more than three consecutive months but were successfully treated with radical endoscopic antrum surgery (REAS) performed with the endoscopic ethmoidectomy procedure.
RESULTS
Compared to outcomes associated with conventional functional endoscopic sinus surgery (FESS), the results remained excellent during follow-ups of more than six months. Postoperative endoscopic examinations and CT scans showed air-filled antrum spaces, and resultant delays in the development of the maxillary sinus were slight (13%) when compared with the contralateral side after FESS.
CONCLUSION
: The immediate outcome of REAS suggests success, but untoward effects on growth of the facial bone should be evaluated with follow-up observations over the long term.