Functional endonasal sinus surgery (FESS) is becoming the procedure of choice for the surgical treatment of chronic and recurrent sinusitis in adults and children. Retrospective analysis of the charts of 513 adult and 260 pediatric patients who underwent FESS after failing to respond to optimal medical treatment revealed an improvement rate of approximately 80% for both age groups. Although high response rates and low complication rates were found for both groups, there were significant differences in indications, preoperative evaluation, operative technique, and methods of postoperative follow-up for children.

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.

Revision functional endonasal sinus surgery (FESS) is recommended for patients whose symptoms of chronic or recurrent sinusitis persist despite primary FESS, long-term maximal medical therapy, and no sign of other abnormalities as demonstrated by computed tomography. After analyzing the charts of 673 patients who underwent primary FESS, we reviewed the 63 cases of revision surgery performed between 1986 and 1989. This retrospective analysis presents the management and outcome of 16 children (<16 years) and 47 adults who had revision FESS. The overall success rate of revision FESS was 78%, with no major complications, reflecting the improved management of sinus disease offered by this procedure.

Tonsillectomy is one of the most common operations performed in the pediatric age group. Previous literature on morbidity in tonsillectomy has dealt predominantly with postoperative hemorrhage. Children undergoing tonsillectomy were divided in a prospective and random fashion into eight study groups to evaluate postoperative morbidity as it relates to the surgical technique used (electrocautery, dissection, KTP laser), methods of hemostasis (electrocautery, suture ligature), and the use of postoperative antibiotics. A total of 80 children were evaluated. Using the parameters of morbidity as defined in this study, blunt dissection tonsillectomy using suture ligatures for hemostasis, without postoperative antibiotics was found to result in the least morbidity in the pediatric age group.