Chloe Harrington, Ibrahim Ibrahim, Bezadpour Hengameh, Alexandra Espinel, Habib G Zalzal
Division of Otolaryngology-Head & Neck Surgery, Children's National Medical Center, Washington, D.C, USA.
Division of Otolaryngology-Head & Neck Surgery, Children's National Medical Center, Washington, D.C, USA.
Int J Pediatr Otorhinolaryngol. 2025 Jan;188:112213. doi: 10.1016/j.ijporl.2024.112213. Epub 2024 Dec 24.
To examine safety and efficacy of very young patients under the age of six who underwent endoscopic sinus surgery (ESS) at our institution for the indications of either complicated acute rhinosinusitis (ARS) or chronic rhinosinusitis (CRS).
Retrospective cohort review of patients under six years old who underwent ESS for sinonasal pathology between 2016 and 2023 at a freestanding pediatric hospital. Age, sex, weight, diagnosis, laterality of disease, medications, types and number of surgical interventions, usage of image guidance, and outcomes were obtained from the medical record.
A total of 25 patients met inclusion criteria (range 1 month-5 years). Eighteen of the patients underwent surgery for an indication of complicated ARS and 7 patients underwent surgery for CRS. Ages were separated into three categories, <1 year (n = 1), 1-3 year (n = 3), 3-6 year (n = 21). Chi squared testing between these three age groups revealed no significant differences in revision rates. There were 5 children who required revision surgery, 3 of which had CRS. Ages of the children who required revision ranged from 2 to 4 years old. There was only one surgical complication observed.
Endoscopic sinus surgery has been increasingly considered safe in pediatric otolaryngology, however, our database in particular focuses on a very young subset of these patients in which there were very few (one) morbidities and no mortalities. Further study of this population should be continued to determine long term outcomes; however, it should be considered safe in acute situations.
Level 4.
研究我院6岁以下因复杂性急性鼻-鼻窦炎（ARS）或慢性鼻-鼻窦炎（CRS）接受鼻内镜鼻窦手术（ESS）的极幼龄患者的安全性和有效性。
对2016年至2023年在一家独立儿科医院因鼻窦病变接受ESS的6岁以下患者进行回顾性队列研究。从病历中获取年龄、性别、体重、诊断、疾病侧别、用药情况、手术干预的类型和数量、图像引导的使用情况及结果。
共有25例患者符合纳入标准（年龄范围1个月至5岁）。其中18例患者因复杂性ARS接受手术，7例患者因CRS接受手术。年龄分为三类，<1岁（n = 1），1 - 3岁（n = 3），3 - 6岁（n = 21）。这三个年龄组之间的卡方检验显示翻修率无显著差异。有5名儿童需要翻修手术，其中3名患有CRS。需要翻修的儿童年龄在2至4岁之间。仅观察到1例手术并发症。
鼻内镜鼻窦手术在小儿耳鼻咽喉科已越来越被认为是安全的，然而，我们的数据库特别关注这些患者中极幼龄的一个亚组，该亚组中发病率极低（1例）且无死亡病例。应继续对该人群进行进一步研究以确定长期结果；然而，在急性情况下应认为其是安全的。
4级。
