Abstract

Background: Sinus disease is a common source of morbidity for many children. Around 5-13% of all upper respiratory infections are complicated by secondary bacterial infection of the paranasal sinuses. Nasal mass in paediatric population is very rare which can be either congenital or acquired.Surgery in these conditions is challenging because of the risk of anaesthesia and a narrow nasal space.

Objectives

1. To study the etiology of disease of Paranasal sinuses in paediatric population requiring endoscopic sinus surgery.

2. To study intra-operative challenges while performing endoscopic sinus surgery in paediatric age group

Method: A retrospective cum prospective study of 30 pediatric patients (age ranging from 0 to 12 years old children) was conducted at our tertiary care centre from June 2016 to December 2018. After detailed imaging and clinical evaluation, all patients underwent endoscopic sinus surgery.

Result: In our study period, out of 30 patients, Dacryocystitis (total 6), Orbital cellulitis (total 6), Juvenile nasopharyngeal angiofibroma (total 6), and Antrochoanal polyp (total 5) constituted the majority. Three patients had Meningocoele and one each of Ossifying fibroma, Choanal Atresia, Sub periosteal hematoma and orbital floor fracture. All of them were treated endoscopically with good success rate. Only 2 patients had recurrence, which was managed endoscopically. Rest all were fine during follow-up.

Conclusion: Functional endoscopic sinus surgery is minimally invasive, so it is very feasible in paediatric population. A thorough knowledge of anatomy and basic experience in adult endoscopic sinus surgery is mandatory. There is a learning curve; as here, one needs to manipulate instruments within a narrow nasal cavity.

Keywords: Endoscopic; Paediatric; Sinus; Nasal mass; Dacryocystitis; Complication; Challenges; Micro instruments; Anatomy; Imaging