Endoscopic Sinus Surgery for Children
Endoscopic sinus surgery is a
procedure to open the passages of the nose and sinuses. It is done to treat long-term
(chronic) sinus infections. An ear, nose, and throat specialist (ENT or
otolaryngologist) does the surgery.
This surgery is called endoscopic
because a tube called an endoscope is used. This is a small, rigid tube with a light
a camera at the end. The surgeon passes the endoscope into the nose and then uses
tools to do the surgery.
Different procedures may be done. They include:
Removal of adenoids with or without sinus wash. Adenoids are small glands behind the nose. Adenoids may cause problems with the sinuses.
The sinuses may be washed (irrigated). The fluid is collected and sent to the lab
to check for infection.
Balloon sinus dilation. Small
balloons are inflated along the natural drainage pathways of the sinuses to widen
(dilate) them. This lets the sinuses drain better.
Functional endoscopic sinus surgery.
The surgeon uses an endoscope during surgery to open sinus passages, remove
growths, or fix other problems such as deviated or crooked cartilage.
Sinus surgery is much less common
in children compared with adults. In children, sinus surgery is often done only for
chronic sinusitis when medical treatment has not helped. Chronic sinusitis means the
infection has lasted for at least 3 months. Medical treatment includes antibiotic
Surgery for short-term (acute) sinusitis is only done when a child has other serious
infections near the sinuses.
Complications of the surgery are rare but include:
- Damage to the eye or eyesight
- Complications with anesthesia
- Complications with the brain, such as
injury, fluid leak, or infection
The ENT healthcare provider will
examine your child’s ears, nose, and throat. Your child may need tests, such as a
scan of the sinuses. Your child’s ENT will explain your child’s surgery.
Make sure you talk with your child’s ENT about the following:
- Any medicines that your child
shouldn't take before surgery. This includes over-the-counter medicines.
- When your child needs to stop eating and drinking. It is common not to eat or drink
after midnight the night before surgery.
- When your child needs to arrive at the hospital or facility
- What to expect and how to care for your child after surgery
- When your child can get back to normal activities, including returning to day care
If your child gets sick before
surgery, call theirENT. Surgery may need to be rescheduled.
During the Test
The surgery often takes from 1 to 3
hours. In general, you can expect the following:
- Your child will be given medicine to sleep (general anesthesia).
- Small cuts are made inside your child’s nose.
- Using the endoscope, the ENT opens the passages of your child’s sinuses and makes
the narrow passages wider.
- At this time, the ENT may wash the sinuses. The liquid is then checked for infection.
- Your child’s adenoids may be removed. This is done through the mouth.
- If needed, other procedures may be
done. For example, the ENT may fix the nasal septum that divides the nose, remove
tonsils, or place ear tubes. These additional surgeries would be discussed with you
beforehand and are not generally part of an endoscopic sinus surgery
After the Test
Your child may need a stay in the
hospital overnight or may go home the same day as the surgery.
- Your child will get IV (intravenous)
fluids until going home. Your child may be given clear liquids to drink in the
- Your child may have a sore nose,
bleeding from the nose, trouble breathing through the nose, and trouble
- Your child may be given medicine for
pain or antibiotic medicine to prevent or treat infection.
- The head of the bed in the recovery
room will be raised to help with swelling, breathing, and drainage. At home you
should have pillows or a recliner chair available. This is to help your child keep
their head raised (elevated) above chest level.
- There may be gauze or cotton packing in your child’s nose to prevent bleeding. The
packing may dissolve on its own or the ENT may remove it.
- At first, there may be some drainage from the nose. The drainage may have a small
amount of blood. Your child may cough or spit up some pink or brown mucus.
- Your child’s ENT may advise that your
child use nasal ointment, saltwater or saline spray, or nasal steroid spray after
surgery. Follow directions carefully.
- A visit with your child’s healthcare provider will be scheduled for 1 to 2 weeks after
surgery. Your child will need other follow-up appointments in the months after surgery.
These are to make sure that the nose and sinuses are healing as they should.
Before you agree to the test or the procedure for your child make sure you know:
- The name of the test or procedure
- The reason your child is having the test or procedure
- What results to expect and what they mean
- The risks and benefits of the test or procedure
- When and where your child is to have the test or procedure
- Who will do the procedure and what that person’s qualifications are
- What would happen if your child did not have the test or procedure
- Any alternative tests or procedures to think about
- When and how you will get the
- Who to call after the test or procedure if you have questions or your child has problems
- How much you will have to pay for the
test or procedure