Endoscopic sinus surgery for pediatric patients: Prognostic factors related to revision surgery

Objectives In the past two decades, endoscopic sinus surgery (ESS) has been performed frequently in children with medically recalcitrant chronic rhinosinusitis (CRS). However, surgical success rates vary according to age. The causes of failure and prognostic factors for revision ESS remain unclear....

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Veröffentlicht in:The Laryngoscope 2020-04, Vol.130 (4), p.1051-1055
Hauptverfasser: Wu, Pei‐Wen, Huang, Chien‐Chia, Yang, Shih‐Wei, Huang, Yenlin, Huang, Chi‐Che, Chang, Po‐Hung, Lee, Yun‐Shien, Lee, Ta‐Jen
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container_end_page 1055
container_issue 4
container_start_page 1051
container_title The Laryngoscope
container_volume 130
creator Wu, Pei‐Wen
Huang, Chien‐Chia
Yang, Shih‐Wei
Huang, Yenlin
Huang, Chi‐Che
Chang, Po‐Hung
Lee, Yun‐Shien
Lee, Ta‐Jen
description Objectives In the past two decades, endoscopic sinus surgery (ESS) has been performed frequently in children with medically recalcitrant chronic rhinosinusitis (CRS). However, surgical success rates vary according to age. The causes of failure and prognostic factors for revision ESS remain unclear. The aims of the present study were to evaluate prognostic factors related to revision surgery after ESS, and to determine the most optimal timing for surgery in the pediatric population. Methods This was a retrospective review in a tertiary medical center. Children who underwent ESS for CRS between 2004 and 2017 were enrolled. Demographics, sinonasal examination findings, previous operation history, laboratory data, comorbidities, and computed tomography (CT) results were collected from medical records. Prognostic factors for revision surgery were analyzed. Results A total of 188 pediatric patients were enrolled in this study. Twenty‐four patients (12.8%) required revision surgery. Multivariate logistic regression analysis identified patients with nasal allergy (OR = 6.258; P = .010) and higher Lund‐Mackay score on preoperative sinus CT (OR = 1.658; P = .043) had worse outcomes, while older age was a positive prognostic factor (OR = 0.702; P = .018). A cut‐off point of 15.68 years of age and mean Lund‐Mackay score of 10.5 showed the best predictive power for revision surgery. Conclusion Because ESS is performed with increasing frequency in children, knowledge of prognostic factors for revision surgery is important. In this study, patients with younger age, nasal allergy, and higher Lund‐Mackay score on preoperative sinus CT had worse outcomes. Level of Evidence 4 Laryngoscope, 130:1051–1055, 2020
doi_str_mv 10.1002/lary.28106
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However, surgical success rates vary according to age. The causes of failure and prognostic factors for revision ESS remain unclear. The aims of the present study were to evaluate prognostic factors related to revision surgery after ESS, and to determine the most optimal timing for surgery in the pediatric population. Methods This was a retrospective review in a tertiary medical center. Children who underwent ESS for CRS between 2004 and 2017 were enrolled. Demographics, sinonasal examination findings, previous operation history, laboratory data, comorbidities, and computed tomography (CT) results were collected from medical records. Prognostic factors for revision surgery were analyzed. Results A total of 188 pediatric patients were enrolled in this study. Twenty‐four patients (12.8%) required revision surgery. Multivariate logistic regression analysis identified patients with nasal allergy (OR = 6.258; P = .010) and higher Lund‐Mackay score on preoperative sinus CT (OR = 1.658; P = .043) had worse outcomes, while older age was a positive prognostic factor (OR = 0.702; P = .018). A cut‐off point of 15.68 years of age and mean Lund‐Mackay score of 10.5 showed the best predictive power for revision surgery. Conclusion Because ESS is performed with increasing frequency in children, knowledge of prognostic factors for revision surgery is important. In this study, patients with younger age, nasal allergy, and higher Lund‐Mackay score on preoperative sinus CT had worse outcomes. Level of Evidence 4 Laryngoscope, 130:1051–1055, 2020</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.28106</identifier><identifier>PMID: 31169921</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley &amp; Sons, Inc</publisher><subject>Age ; chronic rhinosinusitis ; endoscopic sinus surgery ; Endoscopy ; Pediatric sinusitis ; Pediatrics ; recurrence ; revision surgery ; Rhinitis ; Sinuses ; Sinusitis ; Surgery ; Surgical outcomes</subject><ispartof>The Laryngoscope, 2020-04, Vol.130 (4), p.1051-1055</ispartof><rights>2019 The American Laryngological, Rhinological and Otological Society, Inc.</rights><rights>2020 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3576-6f70c9692628e77e6bc3f8b51ebf91786ce77d6ef668a4be9a5bcf856d94af4c3</citedby><cites>FETCH-LOGICAL-c3576-6f70c9692628e77e6bc3f8b51ebf91786ce77d6ef668a4be9a5bcf856d94af4c3</cites><orcidid>0000-0002-9647-1135 ; 0000-0001-7549-9633 ; 0000-0001-8725-6209 ; 0000-0002-0979-7912</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.28106$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.28106$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31169921$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Pei‐Wen</creatorcontrib><creatorcontrib>Huang, Chien‐Chia</creatorcontrib><creatorcontrib>Yang, Shih‐Wei</creatorcontrib><creatorcontrib>Huang, Yenlin</creatorcontrib><creatorcontrib>Huang, Chi‐Che</creatorcontrib><creatorcontrib>Chang, Po‐Hung</creatorcontrib><creatorcontrib>Lee, Yun‐Shien</creatorcontrib><creatorcontrib>Lee, Ta‐Jen</creatorcontrib><title>Endoscopic sinus surgery for pediatric patients: Prognostic factors related to revision surgery</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>Objectives In the past two decades, endoscopic sinus surgery (ESS) has been performed frequently in children with medically recalcitrant chronic rhinosinusitis (CRS). However, surgical success rates vary according to age. The causes of failure and prognostic factors for revision ESS remain unclear. The aims of the present study were to evaluate prognostic factors related to revision surgery after ESS, and to determine the most optimal timing for surgery in the pediatric population. Methods This was a retrospective review in a tertiary medical center. Children who underwent ESS for CRS between 2004 and 2017 were enrolled. Demographics, sinonasal examination findings, previous operation history, laboratory data, comorbidities, and computed tomography (CT) results were collected from medical records. Prognostic factors for revision surgery were analyzed. Results A total of 188 pediatric patients were enrolled in this study. Twenty‐four patients (12.8%) required revision surgery. Multivariate logistic regression analysis identified patients with nasal allergy (OR = 6.258; P = .010) and higher Lund‐Mackay score on preoperative sinus CT (OR = 1.658; P = .043) had worse outcomes, while older age was a positive prognostic factor (OR = 0.702; P = .018). A cut‐off point of 15.68 years of age and mean Lund‐Mackay score of 10.5 showed the best predictive power for revision surgery. Conclusion Because ESS is performed with increasing frequency in children, knowledge of prognostic factors for revision surgery is important. In this study, patients with younger age, nasal allergy, and higher Lund‐Mackay score on preoperative sinus CT had worse outcomes. Level of Evidence 4 Laryngoscope, 130:1051–1055, 2020</description><subject>Age</subject><subject>chronic rhinosinusitis</subject><subject>endoscopic sinus surgery</subject><subject>Endoscopy</subject><subject>Pediatric sinusitis</subject><subject>Pediatrics</subject><subject>recurrence</subject><subject>revision surgery</subject><subject>Rhinitis</subject><subject>Sinuses</subject><subject>Sinusitis</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kE1LwzAYgIMoOqcXf4AUvIjQmbRNmngbMj9goIiCnkKavpFI19SkVfbvzZzz4MFLEt734SE8CB0RPCEYZ-eN8stJxglmW2hEaE7SQgi6jUZxmaecZs97aD-EN4xJmVO8i_ZyQpgQGRkhOWtrF7TrrE6CbYeQhMG_gl8mxvmkg9qq3sddp3oLbR8uknvvXlsX-jg0SvfOh8RDo3qok97F54cN1rUbzQHaMaoJcPhzj9HT1ezx8iad313fXk7nqc5pyVJmSqwFExnLOJQlsErnhleUQGUEKTnTcVozMIxxVVQgFK204ZTVolCm0PkYna69nXfvA4ReLmzQ0DSqBTcEmeUFxnR1RvTkD_rmBt_G30Wq5EQITkWkztaU9i4ED0Z23i5iaUmwXGWXq-zyO3uEj3-UQ7WA-hfddI4AWQOftoHlPyo5nz68rKVfCZyO8Q</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>Wu, Pei‐Wen</creator><creator>Huang, Chien‐Chia</creator><creator>Yang, Shih‐Wei</creator><creator>Huang, Yenlin</creator><creator>Huang, Chi‐Che</creator><creator>Chang, Po‐Hung</creator><creator>Lee, Yun‐Shien</creator><creator>Lee, Ta‐Jen</creator><general>John Wiley &amp; Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9647-1135</orcidid><orcidid>https://orcid.org/0000-0001-7549-9633</orcidid><orcidid>https://orcid.org/0000-0001-8725-6209</orcidid><orcidid>https://orcid.org/0000-0002-0979-7912</orcidid></search><sort><creationdate>202004</creationdate><title>Endoscopic sinus surgery for pediatric patients: Prognostic factors related to revision surgery</title><author>Wu, Pei‐Wen ; Huang, Chien‐Chia ; Yang, Shih‐Wei ; Huang, Yenlin ; Huang, Chi‐Che ; Chang, Po‐Hung ; Lee, Yun‐Shien ; Lee, Ta‐Jen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3576-6f70c9692628e77e6bc3f8b51ebf91786ce77d6ef668a4be9a5bcf856d94af4c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age</topic><topic>chronic rhinosinusitis</topic><topic>endoscopic sinus surgery</topic><topic>Endoscopy</topic><topic>Pediatric sinusitis</topic><topic>Pediatrics</topic><topic>recurrence</topic><topic>revision surgery</topic><topic>Rhinitis</topic><topic>Sinuses</topic><topic>Sinusitis</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Pei‐Wen</creatorcontrib><creatorcontrib>Huang, Chien‐Chia</creatorcontrib><creatorcontrib>Yang, Shih‐Wei</creatorcontrib><creatorcontrib>Huang, Yenlin</creatorcontrib><creatorcontrib>Huang, Chi‐Che</creatorcontrib><creatorcontrib>Chang, Po‐Hung</creatorcontrib><creatorcontrib>Lee, Yun‐Shien</creatorcontrib><creatorcontrib>Lee, Ta‐Jen</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Pei‐Wen</au><au>Huang, Chien‐Chia</au><au>Yang, Shih‐Wei</au><au>Huang, Yenlin</au><au>Huang, Chi‐Che</au><au>Chang, Po‐Hung</au><au>Lee, Yun‐Shien</au><au>Lee, Ta‐Jen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endoscopic sinus surgery for pediatric patients: Prognostic factors related to revision surgery</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2020-04</date><risdate>2020</risdate><volume>130</volume><issue>4</issue><spage>1051</spage><epage>1055</epage><pages>1051-1055</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objectives In the past two decades, endoscopic sinus surgery (ESS) has been performed frequently in children with medically recalcitrant chronic rhinosinusitis (CRS). However, surgical success rates vary according to age. The causes of failure and prognostic factors for revision ESS remain unclear. The aims of the present study were to evaluate prognostic factors related to revision surgery after ESS, and to determine the most optimal timing for surgery in the pediatric population. Methods This was a retrospective review in a tertiary medical center. Children who underwent ESS for CRS between 2004 and 2017 were enrolled. Demographics, sinonasal examination findings, previous operation history, laboratory data, comorbidities, and computed tomography (CT) results were collected from medical records. Prognostic factors for revision surgery were analyzed. Results A total of 188 pediatric patients were enrolled in this study. Twenty‐four patients (12.8%) required revision surgery. Multivariate logistic regression analysis identified patients with nasal allergy (OR = 6.258; P = .010) and higher Lund‐Mackay score on preoperative sinus CT (OR = 1.658; P = .043) had worse outcomes, while older age was a positive prognostic factor (OR = 0.702; P = .018). A cut‐off point of 15.68 years of age and mean Lund‐Mackay score of 10.5 showed the best predictive power for revision surgery. Conclusion Because ESS is performed with increasing frequency in children, knowledge of prognostic factors for revision surgery is important. In this study, patients with younger age, nasal allergy, and higher Lund‐Mackay score on preoperative sinus CT had worse outcomes. 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subjects Age
chronic rhinosinusitis
endoscopic sinus surgery
Endoscopy
Pediatric sinusitis
Pediatrics
recurrence
revision surgery
Rhinitis
Sinuses
Sinusitis
Surgery
Surgical outcomes
title Endoscopic sinus surgery for pediatric patients: Prognostic factors related to revision surgery
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