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Maj Eric A. Mair, MC; Maj William E Bolger, MC; Eric A. Breisch, PhD

Arch Otolaryngol Head Neck Surg. 1995;121(5):547-552.

Abstract
Objective
To determine the effect of functional endoscopic sinus surgery (FESS) on facial skeletal growth in children.

Design
Prospective randomized controlled animal study; retrospective histopathologic study of pediatric FESS specimens.

Setting
Academic tertiary referral medical center.

Participants
Eight newly weaned piglets; uncinate and ethmoid bone of FESS specimens from 84 children.

Interventions
The piglets underwent unilateral FESS. When they had developed to nearly adult size, computed tomography was used to compare facial and sinus development between the surgical and nonsurgical sides. The paranasal sinus contents from children were histologically examined to analyze bone types with respect to patient age.

Outcome Measures
Sinus development and facial skeletal growth after FESS in piglets; histologic maturity of sinus bone in children.

Results
Facial growth in piglets was significantly reduced on the side treated by FESS. When compared with the side that did not undergo the operation, growth reached only 57% in the maxillary sinus and 65% in the ethmoid region. Children younger than 9 years had woven (immature) bone; children 9 years and older had predominantly lamellar (mature) bone.

Conclusions
This preliminary study shows that even limited surgery in the anterior ethmoid region can affect sinus and facial growth in the piglet. Review of corresponding human histologic specimens suggests that further investigation is warranted to rule out the possibility of facial and sinus growth disturbance after this surgery in children.

(Arch Otolaryngol Head Neck Surg. 1995;121:547-552)

Author Affiliations
USAF; USAF

From the Clinical Investigation Facility and Department of Otolaryngology, Wilford Hall US Air Force Medical Center, San Antonio, Tex (Drs Mair and Bolger), and the Department of Pathology, Children's Hospital and Health Center, San Diego, Calif (Dr Breisch). Dr Mair is now with the Department of Otolaryngology, Royal Air Force, Lakenheath, England. Dr Bolger is now with the Uniformed Services University of the Health Sciences, Bethesda, Md.

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