Meta-analysis of outcomes of pediatric functional endoscopic sinus surgery

Objective: To create a consensus of outcomes of pediatric functional endoscopic sinus surgery (FESS) and assess its effectiveness and safety. Study Design: A meta-analysis of the literature on outcomes of pediatric FESS, Methods: A meta-analysis of the literature was performed focusing on the number of patients per study, length of follow-up, prospective versus retrospective, and the separation or exclusion of patients with significant underlying systemic diseases (cystic fibrosis and immunodeficiencies). A rating scale based on the above criteria was used to select articles for inclusion, Results: Eight published articles (832 patients) plus unpublished data from the authors' institution (50 patients) were included, The "positive" outcome rates for published, unpublished, and combined data were 88.4%, 92%, and 88.7%, respectively. No statistically significant differences in "positive" outcome existed between all published or unpublished series using a chi-squared test (power = .51, P = .38), The average combined follow-up was 3.7 years, with a major complication rate of 0.6%. Conclusion: Pediatric FESS is a safe and effective treatment for chronic sinusitis that is refractory to medical therapy.