Pediatric endoscopic sinus surgery: Revisited 35 years later

Over the past 35 years, pediatric endoscopic sinus surgery (PESS) has significantly evolved from its inception as a novel intervention to become a cornerstone in the management of pediatric sinus disorders. This evolution is reflective of a broader shift towards a more nuanced understanding and treatment of pediatric chronic rhinosinusitis (PCRS), marked by the introduction of comprehensive guidelines and the refinement of surgical indications. Recent literature and the extensive experience of the senior author, who has been at the forefront of utilizing PESS since its inception, highlight a noticeable shift in the procedure's utilization. This paper reviews the journey of PESS, highlighting the impact of advancements in medical treatment modalities, such as improved diagnostic techniques and the adoption of less invasive procedures. The development and optimization of PESS are discussed in the context of changing practice patterns, including the prevalent use of adenoidectomy and the selective application of PESS for refractory cases. An emphasis is placed on the outcomes associated with different surgical interventions for PCRS, highlighting their efficacy in alleviating symptoms and managing underlying conditions. The paper concludes by emphasizing the importance of ongoing innovation and collaborative research in further refining surgical techniques and expanding treatment options, with the ultimate goal of delivering safe, effective, and patient-centered care to children with sinus-related disorders. This retrospective analysis demonstrates a commitment to enhancing the quality of life for pediatric patients, reflecting the substantial progress achieved in the field of pediatric otolaryngology over the last three decades.