Sinus and facial growth after pediatric endoscopic sinus surgery.
OBJECTIVE
To determine the effect of functional endoscopic sinus surgery (FESS) on facial skeletal growth in children.


METHODS
Prospective randomized controlled animal study; retrospective histopathologic study of pediatric FESS specimens.


METHODS
Academic tertiary referral medical center.


METHODS
Eight newly weaned piglets; uncinate and ethmoid bone of FESS specimens from 84 children.


METHODS
The piglets underwent unilateral FESS. When they had developed to nearly adult size, computed tomography was used to compare facial and sinus development between the surgical and nonsurgical sides. The paranasal sinus contents from children were histologically examined to analyze bone types with respect to patient age.


METHODS
Sinus development and facial skeletal growth after FESS in piglets; histologic maturity of sinus bone in children.


RESULTS
Facial growth in piglets was significantly reduced on the side treated by FESS. When compared with the side that did not undergo the operation, growth reached only 57% in the maxillary sinus and 65% in the ethmoid region. Children younger than 9 years had woven (immature) bone; children 9 years and older had predominantly lamellar (mature) bone.


CONCLUSIONS
This preliminary study shows that even limited surgery in the anterior ethmoid region can affect sinus and facial growth in the piglet. Review of corresponding human histologic specimens suggests that further investigation is warranted to rule out the possibility of facial and sinus growth disturbance after this surgery in children.
Mair
E A
EA
Clinical Investigation Facility, Wilford Hall US Air Force Medical Center, San Antonio, Tex, USA.
Bolger
W E
WE
Breisch
E A
EA
D000293:Adolescent; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy; D005147:Facial Bones / Q000000981:diagnostic imaging / Q000254:growth & development* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008445:Maxillofacial Development; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000254:growth & development* / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D011859:Radiography; D011897:Random Allocation; D012189:Retrospective Studies; D013552:Swine