Faculty Collaboration Database

Do you need to operate following recovery from complications of pediatric acute sinusitis? Int J Pediatr Otorhinolaryngol 2014 Jun;78(6):923-5

Date

04/08/2014

Pubmed ID

24704319

Pubmed Central ID

PMC4433001

DOI

10.1016/j.ijporl.2014.03.008

Scopus ID

2-s2.0-84899906848 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

OBJECTIVES: There are many studies that evaluate the role of surgery in the treatment of complications of pediatric acute sinusitis; however there are few studies, if any that report the incidence of surgery following recovery from acute complicated sinusitis. The goal of this study was to report the incidence and indications for surgical intervention after recovery from complications of pediatric acute sinusitis.

METHODS: We reviewed the records of all children admitted to a tertiary care children's hospital between January 2005 and September 2010 with a diagnosis of sinusitis and an orbital or intracranial complication. Eighty-six patients met inclusion criteria. Charts were reviewed for type of complication, initial treatment (medical or surgical), type of procedure, secondary procedures, age, and comorbidities. Statistical analysis was completed using independent samples student t-tests and Mann-Whitney tests.

RESULTS: A total of 86 patients with a mean age of 6.38 years (2 months to 18 years) were identified. Eighty patients had orbital complications while six presented with intracranial complications. Twenty-seven patients (31%) underwent sinus surgery during the acute phase of their illness whereas 59 patients (69%) were treated medically. After hospitalization and recovery for acute complicated sinusitis, surgery was performed on nine patients (mean age 4.86 years) within 1 month to 2 years post hospitalization. Of the nine patients who required secondary surgery following resolution of the initial complicated sinusitis, four patients were following initial surgical intervention and five patients had initially resolved their complication with medical therapy alone. Indications for subsequent surgery included failure of medical therapy for persistent rhinosinusitis (8 patients) and second complication (1 patient).

CONCLUSIONS: This study suggests that following resolution of complicated pediatric rhinosinusitis, very few patients may need further surgical intervention. Subsequent intervention is best guided by clinical judgment, symptoms during outpatient clinic visits, and failure of medical therapy.

Author List

Patel RG, Daramola OO, Linn D, Flanary VA, Chun RH

Authors

Robert H. Chun MD Professor in the Otolaryngology department at Medical College of Wisconsin
Valerie A. Flanary MD Director, Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adolescent
Brain Diseases
Child
Child, Preschool
Female
Hospitalization
Humans
Incidence
Infant
Male
Orbital Diseases
Retrospective Studies
Sinusitis
Treatment Outcome
Wisconsin