title: Long-term evaluation after endoscopic sinus surgery for chronic pediatric sinusitis with polyps.
abstract: OBJECTIVE
  Long-term retrospective evaluation was performed of computed tomography (CT) images and endoscopic findings after endoscopic sinus surgery for 88 cases of chronic pediatric sinusitis with nasal polyps. The objective was to determine the appropriate duration of such postoperative evaluation for children.
  
  
  METHODS
  Fifty-one patients had both sinusitis and nasal polyps (BSP group), and the surgical procedure was decided in consideration of each patient's age (for less than 10 years of age, polypectomy (n=12); for 10-13 years old, anterior ethmoidectomy plus opening of the fontanelle and nasofrontal duct (n=20); and for serious cases older than 13 years, total sinusectomy (n=19)). On the other hand, for cases of unilateral sinusitis with antrochoanal polyps (USP group), anterior ethmoidectomy plus opening of the fontanelle was performed regardless of the patient's age (n=37, 5-15 years old).
  
  
  RESULTS
  The postoperative endoscopic findings indicated that the polyps had been eliminated in approximately 91% of total patients. Good postoperative findings of CT images in most patients of USP group are observed at one year after the operation like the same of the postoperative course of adult chronic sinusitis. On the other hand CT images in BSP group evaluated one year after the operation were rated as unchanged or worsened in approximately half of the patients. However, at 4 years after the operation nearly all the patients were rated as improved or better. In addition, comparison of the age at final observation and the postoperative course found a striking decrease in the proportion of unchanged and worsened patients aged 12 and above.
  
  
  CONCLUSIONS
  Accordingly, it was concluded that there is difference of healing process after the operation between USP and BSP group. Postoperative evaluation of BSP group should be performed for 4 years and up to an age of at least 12 years although post-ESS following of USP group is similar to that of adult sinusitis.
authors.affiliation: Department of Otorhinolaryngology, Dokkyo Medical University, 880 Kitakobayashi Mibu-machi, Tochigi, Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Tsukidate
authors.forename: Shinichi
authors.initials: S
authors.lastname: Haruna
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fukami
authors.forename: Itsuo
authors.initials: I
authors.lastname: Nakajima
authors.forename: Wataru
authors.initials: W
authors.lastname: Konno
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Moriyama
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009298:Nasal Polyps / Q000601:surgery*; D010256:Paranasal Sinuses / Q000601:surgery*; D012189:Retrospective Studies; D012852:Sinusitis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult