Texas Children's Hospital - Pediatric Otolaryngology-Head & Neck Surgery.
Texas Children's Hospital - Pediatric Neurosurgery, Baylor College of Medicine - Otolaryngology-Head & Neck Surgery, Houston, Texas, USA.
Curr Opin Otolaryngol Head Neck Surg. 2024 Dec 1;32(6):424-427. doi: 10.1097/MOO.0000000000001016. Epub 2024 Oct 11.
This year marks 10 years from the publication of the clinical consensus statement on pediatric chronic rhinosinusitis (CRS). Balloon sinuplasty did not meet criteria for consensus at that time because there was insufficient evidence on its efficacy and safety. The purpose of this review is to summarize the current evidence on balloon sinuplasty treatment for pediatric CRS.
Balloon sinuplasty is not a cost-effective measure compared to adenoidectomy and endoscopic sinus surgery (ESS). In the pediatric population, benefits include short operative time, reduced tissue manipulation, and potential for decreased antibiotic courses. Alternatively, balloon dilation has increased equipment costs and there is a lack of robust prospective data that fully elucidates balloon sinuplasty's role in the management of pediatric CRS.
Pediatric otolaryngologists should continue to perform first-line adenoidectomy and consider ESS based on imaging and other validated clinical scoring systems. Balloon sinuplasty has not yet been proven as an effective treatment for pediatric CRS and further large-scale investigations are required to overcome its lack of cost-effectiveness.
目的：本文回顾了儿童慢性鼻-鼻窦炎（CRS）临床共识声明发表 10 周年。当时，球囊扩张术因疗效和安全性证据不足，不符合共识标准。本文旨在总结目前关于球囊扩张术治疗儿童 CRS 的证据。
新发现：与腺样体切除术和内镜鼻窦手术（ESS）相比，球囊扩张术不是一种具有成本效益的措施。在儿科人群中，其优势包括手术时间短、组织操作减少以及潜在减少抗生素疗程。然而，球囊扩张术的设备成本增加，并且缺乏充分阐明其在儿童 CRS 管理中作用的强有力的前瞻性数据。
总结：儿科耳鼻喉科医生应继续进行一线腺样体切除术，并根据影像学和其他经过验证的临床评分系统考虑 ESS。球囊扩张术尚未被证明是治疗儿童 CRS 的有效方法，需要进一步进行大规模研究以克服其缺乏成本效益的问题。
