Results of endoscopic sinus surgery in pediatric patients with chronic sinusitis and asthma.
OBJECTIVE
To determine the efficacy of endoscopic sinus surgery in pediatric patients with chronic sinusitis and asthma.


METHODS
Patients were selected from the tertiary care practice of a pediatric pulmonologist (R.S.) and immunologist (R.L.W.); all underwent sinus surgery at Children's Medical Center at Dallas (Tex).


METHODS
Fourteen pediatric patients aged 3.5 to 13 years with severe asthma requiring at least intermittent systemic steroid therapy. All patients had a history of sinusitis aggravating asthma and all had computed tomographic evidence of chronic sinus disease.


METHODS
All patients underwent endoscopic sinus surgery consisting of bilateral total ethmoidectomies and middle meatus antrostomies at a minimum.


METHODS
The period 12 months prior to surgery was compared with 12 months postoperatively with regard to total hospitalization days for asthma treatment, number of school days missed, pulmonary function test results, and systemic glucocorticoid medication requirements. Symptom scores for asthma and sinusitis were assessed via parental questionnaire both preoperatively and postoperatively.


RESULTS
No significant difference was found for pulmonary function test results. Eleven of 14 patients demonstrated a significant reduction in hospitalization and school days missed. Twelve of 14 patients experienced a reduction in glucocorticoid requirements. Eleven of 14 and 13 of 14 patients experienced a significant improvement in asthma and sinusitis symptom scores.


CONCLUSIONS
Endoscopic sinus surgery was effective in reducing sinusitis and improving the overall management of asthma in a majority of study patients.
Manning
S C
SC
Department of Otorhinolaryngology, University of Texas Southwestern Medical Center at Dallas.
Wasserman
R L
RL
Silver
R
R
Phillips
D L
DL
D000041:Absenteeism; D000293:Adolescent; D001249:Asthma / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004724:Endoscopy; D015521:Ethmoid Sinusitis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D008297:Male; D015523:Maxillary Sinusitis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008450:Maximal Midexpiratory Flow Rate / Q000502:physiology; D012574:Schools; D016896:Treatment Outcome
D005938:Glucocorticoids