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Surgical Treatment of Paediatric Chronic Rhinosinusitis

1
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
2
Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(5), 684; https://doi.org/10.3390/jcm8050684
Received: 1 March 2019 / Revised: 26 April 2019 / Accepted: 13 May 2019 / Published: 15 May 2019
(This article belongs to the Special Issue Pediatric Rhinosinusitis and Asthma)
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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. View Full-Text
Keywords: rhinosinusitis; children; surgery; adenoidectomy; balloon sinuplasty; endoscopic sinus surgery rhinosinusitis; children; surgery; adenoidectomy; balloon sinuplasty; endoscopic sinus surgery
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Torretta, S.; Guastella, C.; Ibba, T.; Gaffuri, M.; Pignataro, L. Surgical Treatment of Paediatric Chronic Rhinosinusitis. J. Clin. Med. 2019, 8, 684.

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