Articles Tập 67 Số CĐ13-HNKH Bệnh viện 19-8 09/09/2026

OVERVIEW OF THE OUTCOMES OF FUNCTIONAL ENDOSCOPIC SINUS SURGERY FOR PEDIATRIC CHRONIC RHINOSINUSITIS

Tran Thi Luyen1, Le Anh Tuan2,3, Nguyen Quang Trung1
1 Hanoi Medical University
2 National Otorhinolaryngology Hospital of Vietnam
3 Bệnh viện Tai Mũi Họng Trung Ương
DOI: 10.52163/yhc.v67iCD13.6513
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Keywords
Pediatric chronic rhinosinusitis, functional endoscopic sinus surgery, FESS.
Abstract

Objectives: To review the scientific evidence on the outcomes of functional endoscopic sinus surgery (FESS) in the treatment of pediatric chronic rhinosinusitis (CRS).

Materials and Methods: A scoping review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Studies were identified through PubMed, Google Scholar, ScienceDirect, the Hanoi Medical University Library, and domestic medical journals. Inclusion criteria consisted of clinical studies with full-text availability in either Vietnamese or English, published between January 2010 and December 2025, reporting outcomes of FESS for pediatric CRS.

Results: A total of 13 studies involving 1,456 pediatric patients were included in this review. The overall surgical success rate ranged from 62.5% to over 95%, with nasal obstruction showing the greatest symptomatic improvement (65.3%–90.3%). Postoperative Lund–Mackay scores decreased markedly, and this radiological improvement was sustained in several studies with long-term follow-up extending into adulthood. Quality of life improved significantly, as assessed using the SN-5 questionnaire, Glasgow Children's Benefit Inventory (GCBI), and Sino-Nasal Outcome Test-22 (SNOT-22). Endoscopic sinus surgery demonstrated a favorable safety profile. Major complications were reported in only one study (0.3%), whereas postoperative synechiae were the most common minor complication (5.5%–57.1%), particularly among children younger ≤5 years. The revision surgery rate ranged from 0% to 15.5% and was associated with younger age, higher preoperative Lund–Mackay scores, and the presence of allergic rhinitis.

Conclusions: Functional endoscopic sinus surgery (FESS) is a safe and effective treatment option for children with chronic rhinosinusitis (CRS) who have failed appropriate medical therapy. Current evidence suggests that optimal long-term outcomes require appropriate patient selection, comprehensive perioperative management, mucosal-preserving surgical techniques, close postoperative follow-up, and effective management of underlying comorbidities

References
[1]
1. Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology 2020. 2020;58(Suppl S29):1-464. Google Scholar
[2]
2. Soler ZM, Smith TL. Quality of Life Outcomes after Functional Endoscopic Sinus Surgery. Otolaryngol Clin North Am. 2010;43:605–12. https://doi.org/10.1016/j.otc.2010.03.001 Google Scholar
[3]
3. Benninger MS, Sindwani R, Holy CE, Hopkins C. Early versus delayed endoscopic sinus surgery in patients with chronic rhinosinusitis: impact on health care utilization. Otolaryngol Head Neck Surg. 2015;152:546–52. https://doi.org/10.1177/0194599814565606 Google Scholar
[4]
4. Felisati G, Ramadan H. Rhinosinusitis in children: the role of surgery. Pediatric Allergy and Immunology. 2007;18:68–70. https://doi.org/10.1111/j.1399-3038.2007.00638.x Google Scholar
[5]
5. Haddaway NR, Collins AM, Coughlin D, Kirk S. The Role of Google Scholar in Evidence Reviews and Its Applicability to Grey Literature Searching. PLoS ONE. 2015;10(9):e0138237. https://doi.org/10.1371/journal.pone.0138237 Google Scholar
[6]
6. El Sharkawy AA, Elmorsy SM, Eladl HM. Functional endoscopic sinus surgery in children: predictive factors of outcome. Eur Arch Otorhinolaryngol. 2012;269:107–11. https://doi.org/10.1007/s00405-011-1680-1 Google Scholar
[7]
7. Tsukidate T, Haruna S, Fukami S, Nakajima I, Konno W, Moriyama H. Long-term evaluation after endoscopic sinus surgery for chronic pediatric sinusitis with polyps. Auris Nasus Larynx. 2012;39:583–7. https://doi.org/10.1016/j.anl.2011.10.019 Google Scholar
[8]
8. Thottam PJ, Haupert M, Saraiya S, Dworkin J, Sirigiri R, Belenky WM. Functional endoscopic sinus surgery (FESS) alone versus balloon catheter sinuplasty (BCS) and ethmoidectomy: A comparative outcome analysis in pediatric chronic rhinosinusitis. International Journal of Pediatric Otorhinolaryngology. 2012;76:1355–60. https://doi.org/10.1016/j.ijporl.2012.06.006 Google Scholar
[9]
9. Min H j., Chung H j., Seong S y., Sim N s., Yoon J-H, Lee J-G, et al. Differential characteristics of pediatric sinusitis in patients who underwent endoscopic sinus surgery: children vs. adolescents. Clinical Otolaryngology. 2016;41:579–84. https://doi.org/10.1111/coa.12568 Google Scholar
[10]
10. Thottam PJ, Metz CM, Kieu MC, Dworkin J, Jagini J, Bangiyev JN, et al. Functional Endoscopic Sinus Surgery Versus Balloon Sinuplasty with Ethmoidectomy: A 2-year Analysis in Pediatric Chronic Rhinosinusitis. Indian J Otolaryngol Head Neck Surg. 2016;68:300–6. https://doi.org/10.1007/s12070-015-0839-2 Google Scholar
[11]
11. Sethi G, Chakravarti A. Quality of life after endoscopic sinus surgery in refractory pediatric chronic rhinosinusitis. International Journal of Pediatric Otorhinolaryngology. 2016;90:160–4. https://doi.org/10.1016/j.ijporl.2016.09.005 Google Scholar
[12]
12. Fetta M, Tsilis NS, Segas JV, Nikolopoulos TP, Vlastarakos PV. Functional endoscopic sinus surgery improves the quality of life in children suffering from chronic rhinosinusitis with nasal polyps. International Journal of Pediatric Otorhinolaryngology. 2017;100:145–8. https://doi.org/10.1016/j.ijporl.2017.06.007 Google Scholar
[13]
13. Elsisi H. Safety and efficacy of pediatric functional endoscopic sinus surgery for the treatment of pediatric chronic rhinosinusitis. Egypt J Otolaryngol. 2017;33:616–22. https://doi.org/10.4103/ejo.ejo_7_15 Google Scholar
[14]
14. Wu P-W, Huang C-C, Yang S-W, Huang Y, Huang C-C, Chang P-H, et al. Endoscopic sinus surgery for pediatric patients: Prognostic factors related to revision surgery. The Laryngoscope. 2020;130:1051–5. https://doi.org/10.1002/lary.28106 Google Scholar
[15]
15. Ramadan HH, Bulbul MG, Asad F, Wasef K, Makary CA. Complications of primary pediatric endoscopic sinus surgery for chronic rhinosinusitis: A 25‐year single surgeon experience. Laryngoscope Investig Otolaryngol. 2022;7:658–61. https://doi.org/10.1002/lio2.791 Google Scholar
[16]
16. Makary CA, Bonnici M, Jones G, Sullivan P, Stokes C, Ramadan HH. Long-term follow-up of pediatric chronic rhinosinusitis after surgical treatment. Ann Otol Rhinol Laryngol. 2023;132(11):1400-1403. doi:10.1177/00034894231161417 Google Scholar
[17]
17. Kim D, Ryu G, Hong SD, Yoo SH, Mun SJ, Lee EJ, et al. Clinical Characteristics of Pediatric Chronic Rhinosinusitis: A Nationwide Retrospective Multicenter Study. J Rhinol. Korean Rhinologic Society; 2025;32:28–35. https://doi.org/10.18787/jr.2024.00040 Google Scholar
[18]
18. Davies T, Zammit M, Todd H, Sharma R, Khong G. Elective paediatric functional endoscopic sinus surgery: a tertiary centre experience. The Journal of Laryngology & Otology. 2025;139:1090–4. https://doi.org/10.1017/S0022215125102922 Google Scholar
[19]
19. Brietzke SE, Shin JJ, Choi S, Lee JT, Parikh SR, Pena M, et al. Clinical Consensus Statement: Pediatric Chronic Rhinosinusitis. Otolaryngology–Head and Neck Surgery. 2014;151:542–53. https://doi.org/10.1177/0194599814549302 Google Scholar