Sinus balloon catheter dilation after adenoidectomy failure for children with chronic rhinosinusitis.

OBJECTIVE: To assess surgical outcomes in children undergoing sinus balloon catheter dilation for whom previous adenoidectomy has failed. Adenoidectomy is the first line of surgical management for children with chronic rhinosinusitis (CRS). This procedure is successful in about 50 percent of patients.

DESIGN: Prospective review of children who had surgery for CRS.

SETTING: A referral tertiary health care system.

PATIENTS: Children with persistent symptoms after adenoidectomy, despite medical treatment, as documented by the sinonasal 5 (SN-5) score and the Lund-Mackay computed tomography (CT) score.

MAIN OUTCOME MEASURE: The SN-5 score at 1 year post procedure.

RESULTS: Twenty-six children met the inclusion criteria. The age range was 4 to 12 years (mean [SD] age, 9.0 [2.5] years). The mean (SD) CT score was 7.3 (2.9). The minimum preoperative SN-5 score was 3.0 (mean [SD], 4.6 [0.9]). The mean (SD) time of postoperative follow-up was 13 (3.0) months. The mean (SD) SN-5 score at 1 year was 3.0 (1.2). This was a significant change from preoperative scores (P < .001). Surgical success, measured by a decrease of more than 0.5 on the postoperative SN-5 score, was achieved in 21 children (81%).

CONCLUSIONS: Sinus balloon catheter dilation has previously been shown to be safe and effective in children. This current study demonstrates that balloon dilation is effective in children for whom previous adenoidectomy has failed. Balloon catheter dilation may be considered prior to proceeding to functional endoscopic sinus surgery in children with CRS.