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Review
. 2019 May 15;8(5):684.
doi: 10.3390/jcm8050684.

Surgical Treatment of Paediatric Chronic Rhinosinusitis

Sara Torretta  1   2 , Claudio Guastella  3 , Tullio Ibba  4 , Michele Gaffuri  5 , Lorenzo Pignataro  6   7
Affiliations
Review

Surgical Treatment of Paediatric Chronic Rhinosinusitis

Sara Torretta et al. J Clin Med. .

Abstract

Rhinosinusitis (RS) is a common disease in children, significantly affecting their quality of life. Chronic rhinosinusitis (CRS) is frequently linked to other respiratory diseases, including asthma. Children affected by CRS may be candidates for surgery in the case of failure of maximal medical therapy comprising three to six weeks of broad-spectrum systemic antibiotics with adjunctive therapies. Although endoscopic sinus surgery (ESS) is the surgical treatment of choice in adult patients with CRS, different surgical procedures are scheduled for refractory paediatric CRS and include adenoidectomy, paediatric ESS (PESS), and balloon catheter sinuplasty (BCS). The present paper discusses the indications and limitations of each treatment option in children with CRS. Given the amount of current evidence, it is reasonable to suggest that, in young and otherwise healthy children with refractory CRS, an adenoidectomy (eventually combined with BCS) should be offered as the first-line surgical treatment. Nevertheless, this approach may be considered ineffective in some patients who should be candidates for traditional ESS. In older children, those with asthma, or in the case of peculiar conditions, traditional ESS should be considered as the primary treatment.

Keywords: adenoidectomy; balloon sinuplasty; children; endoscopic sinus surgery; rhinosinusitis; surgery.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Anatomy of the ostiomeatal complex. MT = middle turbinate; IT = inferior turbinate; NS = nasal septum; I = infundibulum; EB = ethmoid bulla.
Figure 2
Figure 2
Protocol treatment. CR = chronic rhinosinusitis; BCS = balloon catheter sinuplasty; ESS = endoscopic sinus surgery.
See this image and copyright information in PMC

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