1996 Volume 39 Issue 6 Pages 620-626
In the treatment of 18 pediatric patients with chronic sinusitis in whom conservative treatment had failed to improve the disease, modified endoscopic sinus surgery (MESS) was performed in 13 patients (5 to 15 years old), while endoscopic sinus surgery (ESS) was performed in 5 patients (13 to 15 years old). These two methods were evaluated and their indication was studied. Two to ten months after operation, CT imaging confirmed opening of the fontanelle of the maxillary sinus and nasofrontal duct in all cases excluding one case. In the patient group undergoing MESS, the rating based on CT imagingwas “markedly improved” in 8 cases, “improved” in one case. The overall rate of improvement in subjective symptoms was 95%. Improvement in oralB breathing, nasal obstruction and headache was especially good, while rhinorrhea and postnasal discharge remained unchanged in one forth of the patients. In the postoperative endoscopic observation of the sinuses, the rating was “markedly improved” in 6 cases, “improved” in 6 cases, “unchanged” in 4 cases, and “worsened” in 2 cases. On the basis of the above results, the following conclusions were reached: It is appropriate to performed MESS in order to maintaiphysiological morphology of developing sinuses for patients who are 12 years old or younger and whoresist to conservative treatment, while it is appropriate to perform ESS for patients who are 13 years old or older and who have severe pathological changes.
