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. 2020 Jan 13:38:e2018068.
doi: 10.1590/1984-0462/2020/38/2018068. eCollection 2020.

SYSTEMATIC REVIEW OF THE LITERATURE ON SURGICAL TREATMENT OF CHRONIC RHINOSINUSITIS IN CHILDREN: WHAT IS THE BEST APPROACH?

[Article in English, Portuguese]
Camila Taniguti Cordeiro Vasco  1 , Heloisa Carvalho de Morais  1 , Melissa Ameloti Gomes Avelino  1
Affiliations

SYSTEMATIC REVIEW OF THE LITERATURE ON SURGICAL TREATMENT OF CHRONIC RHINOSINUSITIS IN CHILDREN: WHAT IS THE BEST APPROACH?

[Article in English, Portuguese]
Camila Taniguti Cordeiro Vasco et al. Rev Paul Pediatr. .

Abstract
in English, Portuguese

Objective: To carry out a systematic literature review on the surgical treatment of chronic rhinosinusitis in the pediatric population.

Data sources: A bibliographic review methodology was used, based on data from National Library of Medicine (Medline), PubMed, Latin American and Caribbean Health Sciences Literature (LILACS) and Scientific Electronic Library Online (SciELO), of the indexed works from 2006 to 2016, including the pediatric population from zero to 13 years of age. The search keywords according to Medical Subject Heading (MESH) and Health Sciences Descriptors (DeCS) were: child, surgery, sinusitis and chronic disease. A total of 318 articles were collected, five of which met the inclusion criteria and were used as a basis for this review. All articles were prospective cohort studies, level of evidence 2B, according to the criterion used by evidence-based medicine.

Data synthesis: The literature agreed that the next step for the cases refractory to drug treatment in chronic rhinosinusitis in childhood would be surgery. Adenoidectomy would be the initial method, for the safety of the procedure and improvement in about 50% of the cases, although more significant results were found in patients who associated this procedure with facial sinus surgery.

Conclusions: Surgical treatment should be indicated for chronic rhinosinusitis in childhood after treatment failure. The results pointed out that adenoidectomy, when associated with some type of approach to the facial sinus, present better results.

Objetivo:: Realizar uma revisão sistemática da literatura sobre o tratamento cirúrgico da rinossinusite crônica na população pediátrica.

Fonte de dados:: Utilizou-se metodologia de revisão bibliográfica, por meio de levantamentos nas bases de dados científicas National Library of Medicine (Medline), PubMed, Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS) e Scientific Electronic Library Online (SciELO), dos trabalhos indexados no período entre 2006 e 2016, incluindo a população pediátrica de zero a 13 anos. Os descritores de busca, segundo o Medical Subject Heading (MESH) e os Descritores em Ciências da Saúde (DeCS), foram: Child, Surgery, Sinusitis e Chronic Disease. Foram levantados 318 artigos, dos quais cinco preencheram os critérios de inclusão e foram usados como base para esta revisão. Todos os artigos foram estudos de coorte prospectivos, nível de evidência 2B, segundo critério usado pela medicina baseada em evidências.

Síntese dos dados:: Foi consenso na literatura que, para os casos refratários ao tratamento medicamentoso na rinossinusite crônica na infância, o próximo passo seria a cirurgia. A adenoidectomia seria o método inicial, pela segurança do procedimento e pela melhora em cerca de 50% dos casos, embora resultados mais significativos terem sido encontrados em pacientes que associaram esse procedimento à cirurgia dos seios da face.

Conclusões:: O tratamento cirúrgico pode ser indicado na rinossinusite crônica na infância após falha terapêutica. Os resultados apontaram que a adenoidectomia, quando associada a algum tipo de abordagem aos seios, apresenta melhores resultados.

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Conflict of interest statement

The authors declare no conflict of interests.

Figures

Figure 1
Figure 1. Flowchart of the methodology utilized in the study.
See this image and copyright information in PMC

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