Thottam Prasad John, Haupert Michael, Saraiya Sonal, Dworkin James, Sirigiri Ranga, Belenky Walter M
Detroit Medical Center, United States; The Children's Hospital of Michigan, United States.
Int J Pediatr Otorhinolaryngol. 2012 Sep;76(9):1355-60. doi: 10.1016/j.ijporl.2012.06.006. Epub 2012 Jul 6.
To evaluate whether the addition of BCS (balloon catheter sinuplasty) would improve the treatment outcome in children with chronic rhinosinusitis (CRS) compared to FESS (functional endoscopic sinus surgery).
Two-group, retrospective cohort with blinded chart review comparison.
Children's Hospital of Michigan, Detroit, MI.
Chart review of 15 pediatric patients who underwent BCS with ethmoidectomy and 16 who underwent FESS from 2008 to 2011 for treatment of CRS in a tertiary care, university affiliated, pediatric institution. Pre-operative CT-scans as well as pre and post-operative sinus symptoms and medications were compared. Post-surgical outcome was examined using chi square analysis.
Mean age of children at the time of the procedure was 9.3 (SD=4.19; range=3-17). Both groups had similar pre-surgical Lund-Mackay CT CRS scores (FESS: mean=9.33 and t=0.67; balloon: mean=10.58, t=0.68, and p=0.51). Analyses identified significant post-treatment reductions in overall symptoms and needed interventions in both treatment groups. Side-by-side post-operative comparison of patients who underwent balloon sinuplasty to FESS demonstrated statistically significant post-operative difference between the two groups in antibiotic requirement, sinus congestion and headaches. Though not statistically significant, 62.5% of FESS patients and 80.0% of BCS patients (χ(2)=1.15) reported improvement in their overall sinus symptoms post-operatively.
Both BCS and FESS are suitable treatments for CRS in children. Both treatments significantly reduced CRS complaints post-operatively and had similar overall results. BCS patients required significantly fewer antibiotics post-operatively for CRS related disease when compared to FESS. Larger prospective studies with long-term data are needed to further evaluate.
评估与功能性鼻内镜鼻窦手术（FESS）相比，增加球囊导管鼻窦成形术（BCS）是否能改善慢性鼻窦炎（CRS）患儿的治疗效果。
两组回顾性队列研究，采用盲法病历审查比较。
密歇根州底特律市的密歇根儿童医院。
对2008年至2011年期间在一家三级医疗、大学附属儿科机构接受BCS联合筛窦切除术的15例儿科患者和接受FESS的16例患者进行病历审查。比较术前CT扫描以及术前和术后的鼻窦症状及用药情况。采用卡方分析检查手术效果。
手术时患儿的平均年龄为9.3岁（标准差=4.19；范围=3 - 17岁）。两组术前的Lund-Mackay CT CRS评分相似（FESS组：平均值=9.33，t = 0.67；球囊组：平均值=10.58，t = 0.68，p = 0.51）。分析发现两个治疗组的总体症状和所需干预措施在治疗后均有显著减少。对接受球囊鼻窦成形术和FESS的患者进行术后并排比较，结果显示两组在抗生素需求、鼻窦充血和头痛方面存在统计学上的显著术后差异。虽然无统计学意义，但62.5%的FESS患者和80.0%的BCS患者（χ(2)=1.15）报告术后总体鼻窦症状有所改善。
BCS和FESS都是治疗儿童CRS的合适方法。两种治疗方法术后均显著减少了CRS症状，总体效果相似。与FESS相比，BCS患者术后因CRS相关疾病所需的抗生素显著减少。需要进行更大规模的前瞻性研究并获取长期数据以进一步评估。
