Middle Meatal Antrostomy Stenting following Pediatric Endoscopic Sinus Surgery

Abstract

Functional endoscopic sinus surgery in the pediatric population is similar to surgery in adults, yet different in many ways. The smaller size of the surgical field, the lesser extent of pneumatization of the sinuses, and the rapidity of the healing process in children result in a higher occurrence of synechiae and of closure of the middle meatal antrostomy. In addition, a second general anesthesia is often necessary, as children do not tolerate the pain of suctioning in the office. An ostiomeatal stent that has previously proved effective in adults is evaluated in 40 children who underwent bilateral ethmoidectomy and maxillary antrostomy. The stent appears to be effective in preventing synechiae and maintaining patency of the middle meatal antrostomy and ventilation of the maxillary sinuses. In addition, once it is removed, the maxillary and ethmoid cavities are relatively cleaner than control, and require minimal postoperative debridement. In the group of children where the stent was placed bilaterally, there was no need for a second general anesthesia for the purpose of suctioning.