Kim Donghyeok, Ryu Gwanghui, Hong Sang Duk, Yoo Shin Hyuk, Mun Sue Jean, Lee Eun Jung, Heo Sung-Jae, Jeong Jin Hyeok, Kim Dae Woo, Cho Hyung-Ju, Rha Min-Seok, Kim Yong Min, Lee Ki-Il, Mo Ji-Hun
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan, Republic of Korea.
J Rhinol. 2025 Mar;32(1):28-35. doi: 10.18787/jr.2024.00040. Epub 2025 Mar 21.
Pediatric chronic rhinosinusitis (CRS) significantly affects children's quality of life and learning abilities. This study aimed to evaluate the postoperative outcomes in pediatric patients who underwent functional endoscopic sinus surgery (FESS) for CRS.
A retrospective review was conducted on pediatric patients who underwent FESS for CRS at 11 university hospitals. The inclusion criteria were patients under 20 years old with bilateral disease who were operated on between January 2005 and December 2021. The data collected included demographics, clinical history, blood tests, preoperative computed tomography, and preoperative and postoperative symptom control. The Kruskal-Wallis and Fisher exact tests were used to compare the quantitative and qualitative data, respectively.
In total, 213 patients were enrolled. The mean age was 13.4±3.0 years, and 145 (68.1%) were male. One hundred sixty-four patients (77.0%) had nasal polyps and 33 patients (15.5%) underwent revision FESS. The preoperative symptoms, in order of prevalence, included nasal obstruction (87.8%), rhinorrhea (71.8%), a sense of postnasal drip (58.2%), hyposmia (44.6%), cough (24.4%), and facial fullness (18.3%). These symptoms were significantly alleviated for up to 3 years after surgery (p<0.001). At the time of the last follow-up, 121 patients (56.8%) were controlled, 80 (37.6%) were partly controlled, and 12 (5.6%) were uncontrolled. Patients in the uncontrolled group had higher Lund-Mackay scores, longer follow-up durations, and more instances of revision surgery compared to those in the controlled and partly controlled groups. When age was categorized into three groups, those aged 16 years or older tended to have lower Lund-Mackay scores and better control.
FESS significantly improves both the postoperative symptoms and the long-term quality of life in pediatric CRS patients. Better symptom control is associated with older age and a lower disease burden.
小儿慢性鼻-鼻窦炎（CRS）严重影响儿童的生活质量和学习能力。本研究旨在评估接受功能性鼻内镜鼻窦手术（FESS）治疗CRS的小儿患者的术后结局。
对11所大学医院中接受FESS治疗CRS的小儿患者进行回顾性研究。纳入标准为20岁以下、患有双侧疾病且于2005年1月至2021年12月期间接受手术的患者。收集的数据包括人口统计学资料、临床病史、血液检查、术前计算机断层扫描以及术前和术后的症状控制情况。分别采用Kruskal-Wallis检验和Fisher精确检验来比较定量和定性数据。
共纳入213例患者。平均年龄为13.4±3.0岁，其中145例（68.1%）为男性。164例患者（77.0%）有鼻息肉，33例患者（15.5%）接受了再次FESS手术。术前症状按发生率排序依次为鼻塞（87.8%）、流涕（71.8%）、鼻后滴漏感（58.2%）、嗅觉减退（44.6%）、咳嗽（24.4%）和面部胀满感（18.3%）。这些症状在术后长达3年的时间里均有显著缓解（p<0.001）。在最后一次随访时，121例患者（56.8%）症状得到控制，80例（37.6%）部分得到控制，12例（5.6%）未得到控制。与症状得到控制和部分得到控制的组相比，未得到控制组的患者Lund-Mackay评分更高、随访时间更长且再次手术的情况更多。将年龄分为三组时，16岁及以上的患者往往Lund-Mackay评分更低且控制情况更好。
FESS显著改善了小儿CRS患者的术后症状和长期生活质量。更好的症状控制与年龄较大和疾病负担较低相关。
