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.