Functional endonasal sinus surgery has become a popular mode of surgical treatment for sinus disease in the United States. The literature has primarily addressed its use in the adult population. We present our series of 57 children who underwent functional endonasal sinus surgery. The children ranged in age from 3 to 15 years. Follow-up was from 3 to 13 months. Fifty-four of the patients were treated for chronic or recurrent sinus infections. Three patients were treated for complications of acute sinusitis. All patients tolerated the procedure well, and there were no major complications. We conclude that functional endonasal sinus surgery is a safe procedure in the pediatric age group. Although postoperative follow-up in the series was very short, early results appear encouraging. The technical approach is similar to that used in the adult procedure. The pediatric procedure, however, requires a follow-up nasal endoscopy under general anesthesia to achieve optimal results.

Malignant external otitis(MEO) is a progressive necrotizing infection which spreads to the skull base. The causative organism is usually Pseudomonas aeruginosa and 90% of the patients are diabetic. The infection gains access to the skull base at the temporal bone. Cranial nerve involvement is common. We present a case of malignant external otitis causing blindness due to optic neuritis. Progressive vascular involvement along the skull base is the pathogenic mechanism that best explains spread from the temporal bone to the orbital apex.

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Glomus tumors of the middle ear are unusual in adults, but exceedingly rare in children. While a dull, red bulging tympanic membrane in the adult may suggest a glomus tumor, it generally signifies infection in the child. This report details our management of a 10-year-old girl afflicted with bilateral chronic middle ear cleft infection that obscured bilateral glomus tumors. Review of the current English language literature reveals seven additional case reports of otologic glomus tumors in children less than fourteen years of age. Two additional cases are presented that were given to the senior author by personal communication, producing a total of 10 cases for review. Glomus tumors in children may be hidden by otitis media and appear more likely to be endocrine active. Failure to cure the lesion is apparent in five of six case reports of children with glomus jugulare tumors; three of these children are reported to have expired. Complete surgical extirpation is advocated for childhood glomus tumors.

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