Is there a future for pediatric sinus surgery? An American perspective.

The role of pediatric sinus surgery in chronic sinusitis continues to evolve. By the early 1990s, endoscopic sinus surgery was being touted as a primary intervention of chronic pediatric sinusitis. Around this same time these endoscopic techniques were being attempted in congenital nasosinus malformations, acute orbital complications of sinusitis and other areas. In 1996 the Brussels consensus paper on pediatric sinusitis recommended that the latter set of nasal disorders were "absolute" indications, and ironically, chronic sinusitis was a "possible indication". This report reviews some of the changes which have impacted the use of sinus surgery during the last decade including the perception of nasal symptoms during the era of antibiotic resistance in bacteria, improved instrumentation, the role of adenoidectomy, research on the effects of sinus surgery on facial growth, and the research on surgical outcomes.