The Effect of Long-Term Follow up on Outcome of Pediatric Endoscopic Sinus Surgery

Sanghyub Kim; Young-Jun Chung; Ji-Hun Mo

doi:10.18787/jr.2019.26.1.32

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Kim, Chung, and Mo: The Effect of Long-Term Follow up on Outcome of Pediatric Endoscopic Sinus Surgery

Original Article

Journal of Rhinology 2019; 26(1): 32-37.

Published online: 31 May 2019

DOI: https://doi.org/10.18787/jr.2019.26.1.32

The Effect of Long-Term Follow up on Outcome of Pediatric Endoscopic Sinus Surgery

Sanghyub Kim, MD, Young-Jun Chung, MD, Ji-Hun Mo, MD

Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University, College of Medicine, Cheonan, Korea.

Corresponding author (jihunmo@gmail.com)

Received 6 April 2018 Revised 9 August 2018 Accepted 29 October 2018

Journal of Rhinology

Abstract

Background and Objectives

Chronic pediatric sinusitis continues to be a challenging problem to otolaryngologists and has been reported to show worse prognosis than that of adults. However, most studies were performed with short-term follow-up. In this study, we aimed to assess the clinical outcome of pediatric endoscopic sinus surgery (ESS) with a longer follow-up and to determine the effect of age on postoperative outcome.

Subjects and Method

A retrospective analysis was performed on pediatric patients than 15 years with ESS younger from 2005 to 2014 in a tertiary referral hospital. All patients completed a questionnaire regarding symptoms before to from 1 to 9 years after surgery. Telephone survey was performed to evaluate symptoms including nasal obstruction, nasal discharge, PND, and headache at 1 to 9 years after surgery.

Results

Seventy-one pediatric patients with bilateral chronic sinusitis were treated with ESS. They showed gradual symptom improvement from 5 year after surgery for the following: nasal obstruction (p=0.032), PND (p=0.005), and headache (p=0.048). However, there was improvement in rhinorrhea after 9 years (p=0.042). In addition, when analyzed in terms of age, the outcome was poor in children younger than 13 years (p=0.003) compared with the older age group. Multivariate analysis showed that preoperative nasal obstruction was dependent on AR, and postoperative symptoms were dependent on presence of AR and involuntary smoking. Nasal discharge was dependent on presence of AR and involuntary smoking preoperatively and postoperatively. These suggest the importance of AR and involuntary smoking as risk factors for prognosis.

Conclusion

Chronic pediatric sinusitis showed gradual improvement after ESS and should be more carefully monitored on a long-term basis. We should keep in mind that long-term follow-up is needed for pediatric ESS cases.

Keywords: Pediatric chronic sinusitis, Rhinosinusitis, Endoscopic sinus surgery

Figures and Tables

Fig. 1

Post-ESS symptom score before and after surgery. Nasal obstruction, PND, headache were gradually improved after 5 years post-ESS (^*p<0.05). A: Nasal obstruction, B: Rhinorrhea, C: PND, D: Headache.

Fig. 2

Stratification of post-ESS evaluation at the time of final observation. When analyzed in terms of age, the outcome was poor in children younger than 13 years of age when compared with older age group (^*p<0.05).

Fig. 3

Stratification of post-ESS evaluation focusing age at the time of final observation. The proportion of moderate and marked improved cases was high in children aged 13 or more.

Table 1

Demographic data and preoperative assessment

Values are presented as number or mean±standard deviation.

AR: Allergic rhinitis

Table 2

Preoperative visual analogue scale symptom score

Values are presented as number or mean±standard deviation.

PND: Post nasal drip

Table 3

Binary logistic regression analysis between VAS differences and covariates

References

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The Effect of Long-Term Follow up on Outcome of Pediatric Endoscopic Sinus Surgery

Abstract

Background and Objectives

Subjects and Method

Results

Conclusion

Figures and Tables

Fig. 1

Post-ESS symptom score before and after surgery. Nasal obstruction, PND, headache were gradually improved after 5 years post-ESS (*p<0.05). A: Nasal obstruction, B: Rhinorrhea, C: PND, D: Headache.

Fig. 2

Stratification of post-ESS evaluation at the time of final observation. When analyzed in terms of age, the outcome was poor in children younger than 13 years of age when compared with older age group (*p<0.05).

Fig. 3

Stratification of post-ESS evaluation focusing age at the time of final observation. The proportion of moderate and marked improved cases was high in children aged 13 or more.

Table 1

Demographic data and preoperative assessment

Table 2

Preoperative visual analogue scale symptom score

Table 3

Binary logistic regression analysis between VAS differences and covariates

References

Post-ESS symptom score before and after surgery. Nasal obstruction, PND, headache were gradually improved after 5 years post-ESS (^*p<0.05). A: Nasal obstruction, B: Rhinorrhea, C: PND, D: Headache.

Stratification of post-ESS evaluation at the time of final observation. When analyzed in terms of age, the outcome was poor in children younger than 13 years of age when compared with older age group (^*p<0.05).