小児鼻副鼻腔手術の検討

抄録

Endoscopic nasal or paranasal sinus surgery is sometimes necessary in children. We reviewed 21 pediatric cases of endoscopic surgery in our department: 10 cases of antrochoanal polyp, 4 cases of blowout fracture, 2 cases of chronic rhinosinusitis with polyposis, and 5 others. The patients consisted of 9 boys and 12 girls, and their average age at the time of surgery was 8.8 years old. All surgeries were performed under general anesthesia and with a 2.7-mm or 4.0-mm rigid endoscope. One case of sphenoid sinus antrochoanal polyp in a girl required revision surgery; simple resection was performed at 3 years of age and again at 5 years of age. Functional endoscopic sinus surgery was performed in an 11-year-old boy and a 14-year-old boy with chronic rhinosinusitis. Their pathology was suspected of being type 2 inflammation in addition to sinobronchitis syndrome, and their sinusitis recurred early after surgery. Although paranasal sinus surgery is uncommon in children, whenever indications are present, it is necessary to tailor the surgical procedure to the individual in view of the patient’s age and growth status. If radical surgery is contraindicated because of the patient’s age, it is important to formulate a long-term treatment strategy at the time of the initial surgery.