Di Cicco Maurizio, Costantini Diana, Padoan Rita, Colombo Carla
ENT Department, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, MD Cystic Fibrosis Centre via Commenda 9, University of Milan, 20122 Milan, Italy.
Int J Pediatr Otorhinolaryngol. 2005 Oct;69(10):1407-13. doi: 10.1016/j.ijporl.2005.03.037.
Sinus mucocele is rare in the paediatric age, and so far no prevalence data have been reported in children with Cystic Fibrosis (CF). Moreover, safety and efficacy of endoscopic management of sinus mucoceles has been widely proven but only in the adult population. The aim of our study was to evaluate the prevalence of this complication and the efficacy of endoscopic sinus surgery in CF patients during the initial years of life. Among the 242 CF patients born in the period between 1990 and 2001 and in regular follow up at our CF Centre, 90 patients with possible symptoms of chronic upper airways disease (CUAD) underwent a comprehensive ENT examination including rhinofibroscopy. In selected cases a CT scan of the paranasal sinuses was also performed. CUAD was diagnosed in 55/90 because of the consistent presence of nasal obstruction, combined with at least two other nasal symptoms such as chronic nasal discharge, snoring, epiphora. Diagnosis of mucoceles (five maxillary bilateral mucoceles, one maxillary unilateral, three maxillary and etmoidal mucoceles) was done by means of CT scan in 9/15 who performed the examination. Median age at the diagnosis was 4+/-0.5 years, ranging from 0.5+/-7 years, showing a prevalence of 16.4% (9/55) among patients with symptoms. Endoscopic sinus surgery was performed in all the cases. The follow-up period ranged from 3 months to 6 years with no recurrence observed. Sinus mucocele in CF population is less unusual than expected and a high degree of suspicion is needed. Endoscopic sinus surgery seems to be a safe and efficient treatment of this complication also in a paediatric population at a high risk as for the CF patients.
鼻窦黏液囊肿在儿童期较为罕见，迄今为止，尚无关于囊性纤维化（CF）患儿的患病率数据报道。此外，内镜治疗鼻窦黏液囊肿的安全性和有效性已在成人中得到广泛证实，但在儿童中尚未有相关研究。本研究的目的是评估CF患者在生命最初几年中这种并发症的患病率以及内镜鼻窦手术的疗效。在1990年至2001年期间出生并在我们CF中心定期随访的242例CF患者中，90例有慢性上呼吸道疾病（CUAD）可能症状的患者接受了包括鼻纤维镜检查在内的全面耳鼻喉科检查。在某些选定病例中，还进行了鼻窦CT扫描。55/90例患者因持续存在鼻塞并伴有至少其他两种鼻部症状，如慢性鼻分泌物、打鼾、流泪，而被诊断为CUAD。在进行检查的15例患者中，9例通过CT扫描诊断为黏液囊肿（5例双侧上颌窦黏液囊肿、1例单侧上颌窦黏液囊肿、3例上颌窦和筛窦黏液囊肿）。诊断时的中位年龄为4±0.5岁，范围为0.5±7岁，在有症状的患者中患病率为16.4%（9/55）。所有病例均接受了内镜鼻窦手术。随访期为3个月至6年，未观察到复发。CF患者中的鼻窦黏液囊肿比预期的更为常见，需要高度怀疑。内镜鼻窦手术似乎也是CF这类高危儿科患者中治疗这种并发症的一种安全有效的方法。
