Surgical intervention to the frontal sinus is rarely pursued in the pediatric population, as the sinus does not begin to pneumatize until around the age of 8, and there is variability in the rate of development. Additionally, chronic frontal rhinosinusitis is often resolved by management of the adenoids and/or maxillary and ethmoid sinuses. Though pediatric frontal sinus surgery is uncommon, a thorough understanding of frontal sinus anatomy, pathology, and management is important for all otolaryngologists as complications of acute sinusitis can result from frontal sinusitis and should be treated expediently. The boundaries of the frontal sinus drainage pathway are complex in the adult and can be even more varied in the pediatric population. Surgery for frontal sinusitis in pediatric patients has been shown to be effective with recent American Academy of Otolaryngology (AAO) clinical consensus statements supporting its use. Surgery for pediatric CRS can take many forms from adenoidectomy to limited endoscopic sinus surgery (ESS) to maxillary antral irrigation to frontal sinusotomy. The specific procedures employed and their indications are a source of controversy, with a wide range of opinions as to what constitutes appropriate surgical intervention. These topics will be covered in greater detail later in this chapter.
KeywordsFrontal sinusitis Pediatric Pediatric sinusitis
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