Comparative analysis of the outcome of external and endoscopic frontal sinus surgery in children.

Background: Both open and functional endoscopic sinus surgery (FESS) are performed in the case of pediatric frontal rhinosinusitis. However, data from comparative analysis of these surgery types are insufficient.Objective: Prospective randomized trial for comparison of open and endoscopic surgery outcome in pediatric chronic rhinosinusitis.Material and methods: The cohort included 30 pediatric patients (7-17 years) with open frontal sinus surgery and 34 patients who underwent FESS using DrafIIa. Lund-Kennedy and Lund-Mackay scores, as well as Sino-Nasal Outcome Test-20 (SNOT-20)questionnaire was used for pre- and postoperative assessment.Results: Open surgery and FESS resulted in a significant improvement in total Lund-Kennedy, Lund-Mackay, and SNOT-20 scores, being more profound in FESS group. Using FESS significantly reduced surgery duration by 15% as compared to open surgery. In addition, open surgery was associated with a higher rate of scar formation, reduced local sensitivity, as well as local soreness, lacrimation, and psychological discomfort. In regression models FESS was negatively associated with postoperative total Lund-Kennedy, Lund-Mackay, and SNOT-20 scores.Conclusion and significance: Generally, FESS resulted in better surgery outcome as compared to open surgery, although both approaches resulted in a significant improvement in chronic rhinosinusitis.