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Cystic fibrosis (CF) is the most common cause of nasal polyps in children. Therefore, any child under 12 to 20 years old with nasal polyps should be tested for CF. [7] [10] Half of people with CF will experience extensive polyps leading to nasal obstruction and requiring aggressive management. [7]
In acute sinusitis, symptoms last for less than 4 weeks. In chronic sinusitis symptoms must be present for at least 12 weeks. [12] In the initial evaluation of sinusitis an otolaryngologist, also known as an ear, nose and throat (ENT) doctor, may confirm sinusitis using nasal endoscopy. [11]
Symptoms include difficulty breathing through the nose, swelling and pain around the nose and eyes, postnasal drainage down the throat, and difficulty sleeping. [10] CRS is a common condition in children and young adults. [11] The purpose of FESS in treatment of CRS is to remove any anatomical obstructions that prevent proper mucosal drainage.
The sphenoid sinus is a paired paranasal sinus in the body of the sphenoid bone. It is one pair of the four paired paranasal sinuses. [1] The two sphenoid sinuses are separated from each other by a septum. Each sphenoid sinus communicates with the nasal cavity via the opening of sphenoidal sinus.
Sinus surgery with balloons may be performed in a hospital, outpatient surgery setting or in the physician’s office under local anesthesia. The physician inserts a guide catheter through the nostril and near the sinus opening under endoscopic visualization. A flexible guide wire is then introduced into the targeted sinus to confirm access.
The World Health Organization recommends using a two step treatment approach based on the level of pain in children. The first step explains mild pain treatment, while the second step considers moderate to severe pain. Opioids, such as morphine, is an example of a drug of choice for moderate-severe pain in children with medical illnesses. [36]
The WHO Model List of Essential Medicines for Children (aka Essential Medicines List for Children [1] or EMLc [1]), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe in children up to twelve years of age to meet the most important needs in a health system.
This treatment has shown good results in aviators who have recurrent sinus barotrauma. Computer-aided surgery has re-established the drainage of affected sinuses, especially with regard to the sphenoid sinuses. [10] When the sphenoids were entered endoscopically, mucosal petechia and hematoma were clearly seen.
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