While endoscopic sinus surgery (ESS) has been found to be an effective therapy in children with chronic rhinosinusitis, comparable outcomes can be achieved with medical therapy and adenoidectomy. A stepwise approach of medical therapy, progressing to adenoidectomy, then to ESS allows children to be treated with a less invasive and more cost-effective interventions as initial therapy, while saving ESS for those who are refractory to primary interventions. Maximal medical therapy should be exhausted prior to surgical intervention for uncomplicated patients. In cases with complications such as orbital or skull base involvement, ESS can be employed more readily. For more information:
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