Timing of endoscopic sinus surgery in children: Is there an impact on outcome?

Objectives/Hypothesis. Endoscopic sinus surgery in children continues to be a controversial issue. Major factors in determining when to operate are th e duration of the disease and duration of medical treatment. Study Design: Prospective study of children referred to a tertiary center. Patients and M ethods: Eighty-three patients underwent endoscopic sinus surgery for refrac tory chronic sinusitis. All patients were followed prospectively to evaluat e their response to surgery for a mean follow-up period of at least 1 year. A chi (2) analysis and logistic regression analysis were performed to dete rmine statistical difference between duration of symptoms and outcome. Resu lts: The overall success rate of endoscopic sinus surgery was 80%. Children who had surgery between 6 and 12 months of symptoms despite continued medi cal therapy had an 84% success rate, those who had surgery between 12 and 1 8 months had a 74% success rate, and those with more than 18 months of trea tment for symptoms had an 81% success rate (P > .05). Conclusions: Duration of the symptoms of chronic sinusitis in children of more than 6 months was not a predictor of success of endoscopic sinus surgery in these children. Although there seemed to be a trend toward having a more successful procedu re in children who had surgery between 6 and 12 months of medical treatment versus those who had surgery after more than 12 months of medical treatmen t, this did not reach statistical significance. A prospective study with mo re patients may shed more light on this subject.