Our Summary

The paper discusses the advancements in pediatric endoscopic sinus surgery (PESS), a method used to treat sinus issues in children, over the last 35 years. The procedure has evolved significantly, largely due to a deeper understanding of pediatric chronic rhinosinusitis (PCRS), a condition which involves long-term inflammation of the nasal passages and sinuses. Improvements have come about due to better diagnosis techniques and the use of less invasive procedures. The paper also talks about changes in how these surgeries are carried out, including the frequent use of adenoidectomy (removal of adenoids) and the selective use of PESS for stubborn cases. The effectiveness of different surgical interventions in relieving symptoms and managing conditions is also discussed. The authors stress the need for continuous innovation and research collaboration to refine surgical techniques and broaden treatment options. The ultimate goal is to provide safe, effective, and patient-focused care for children with sinus disorders. This analysis shows a dedication to improving the quality of life for young patients, which mirrors the major progress made in the field of children’s ear, nose, and throat medicine over the last few decades.

FAQs

  1. What advancements have been made in pediatric endoscopic sinus surgery over the last 35 years?
  2. What changes in procedures are now being used in pediatric endoscopic sinus surgery?
  3. Why is continuous innovation and research collaboration important in the field of pediatric endoscopic sinus surgery?

Doctor’s Tip

A helpful tip a doctor might give a patient about sinus surgery is to follow all pre-operative and post-operative instructions carefully. This includes avoiding certain medications, abstaining from smoking, and taking proper care of the surgical site to prevent complications. Additionally, it may be helpful to discuss any concerns or questions with your healthcare provider before undergoing the procedure. It is important to have realistic expectations about the outcome of the surgery and to be patient with the recovery process. Following these guidelines can help ensure a successful and smooth recovery from sinus surgery.

Suitable For

Patients who are typically recommended sinus surgery include those with chronic rhinosinusitis that does not respond to other treatments, sinus polyps, sinus tumors, deviated septum, nasal obstruction, recurrent sinus infections, and sinus headaches. Children with severe sinus issues that impact their quality of life and overall health may also be candidates for sinus surgery.

Timeline

Before sinus surgery:

  1. Patient experiences symptoms of chronic rhinosinusitis, such as nasal congestion, facial pain, headaches, and postnasal drip.
  2. Patient undergoes diagnostic tests, such as a nasal endoscopy and CT scan, to determine the severity and extent of the sinus issues.
  3. Patient may undergo medical management, such as antibiotics, nasal corticosteroids, and saline irrigation, to try and alleviate symptoms.
  4. If symptoms persist despite medical management, patient may be recommended for sinus surgery.

After sinus surgery:

  1. Patient undergoes endoscopic sinus surgery to remove blockages, open up the sinuses, and improve drainage.
  2. Patient may have adenoidectomy performed at the same time to address any issues with the adenoids.
  3. Patient experiences some discomfort and congestion in the days following surgery, but this typically improves with time.
  4. Patient follows post-operative care instructions, such as nasal saline rinses and avoiding certain activities that could irritate the sinuses.
  5. Patient gradually experiences relief from chronic rhinosinusitis symptoms, with improved nasal breathing, reduced facial pain, and decreased frequency of sinus infections.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with sinus surgery?
  2. How long is the recovery process and what can I expect during this time?
  3. Will I need any follow-up appointments or additional treatments after the surgery?
  4. How likely is it that my symptoms will improve after the surgery?
  5. Are there any alternative treatments or therapies that I should consider before opting for surgery?
  6. How experienced are you in performing sinus surgery, particularly in pediatric patients?
  7. Can you explain the specific surgical technique you plan to use and why?
  8. What type of anesthesia will be used during the surgery and what are the potential side effects?
  9. How long will the effects of the surgery typically last before symptoms may return?
  10. Are there any lifestyle changes or precautions I should take before or after the surgery to optimize my recovery?

Reference

Authors: Purrinos JA, Younis R. Journal: Am J Otolaryngol. 2025 Jan-Feb;46(1):104567. doi: 10.1016/j.amjoto.2024.104567. Epub 2024 Dec 17. PMID: 39719726