Tantimongkolsuk Chirapan, Pornrattanarungsee Suwanna, Chiewvit Pipat, Visitsunthorn Nualanong, Ungkanont Kitirat, Vichyanond Pakit
Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand.
J Med Assoc Thai. 2005 Nov;88 Suppl 8:S149-55.
Sinusitis is a very common disease in childhood. Clinical manifestations in childhood sinusitis are different than in adult. Information in childhood sinusitis in Thailand is limited. We performed a prospective descriptive study to determine clinical characteristics of childhood sinusitis in Thailand
One hundred pediatric patients with clinical diagnosis of sinusitis attending pediatric allergy clinic, pediatric outpatient clinic, and pediatric ENT clinic were recruited. Clinical diagnosis was defined by presence of symptoms indicating upper respiratory infections with exudates at middle meatus by anterior rhinoscopy. Thorough history taking and physical examinations were conducted with findings recording into sinusitis questionnaire. Sinus radiographs were taken in 77 patients and were read blindly a single radiologist who was unaware of clinical conditions of patients. Allergy skin prick tests were performed with a panel of common aeroallergens in Thailand.
Age range of the 100 patients were between 1.7 to 12.4 years with a mean (+/- SD) of 6 +/- 2.72 years. History of atopic disease among patients and their families was positive in 49% and 47% respectively. Four most common clinical manifestations were rhinorrhea (95%), nocturnal and productive cough (91%), nasal congestion (74%) and posterior nasal dripping (66%). The three most common signs were obstruction of middle meatus (100%), swelling of turbinates (92%) and granular pharynx (48%). All paranasal sinuses X-rays were abnormal with maxillary sinus being the most commonly involved sinus (99%) followed by ethmoid sinus (91%). The majority of patients had involvement of more than one sinus. Skin prick tests were positive in 53.6%. The two most common sensitizing allergens were dust mites (57.7) and cockroaches (18.6%).
The presence of symptoms of rhinorrhea, cough, nasal congestion and posterior nasal drip should alert physicians for diagnosis of sinusitis in pediatric patients. Maxillary and ethmoid sinus were the most common sinuses involved. Atopic predisposition is present in up to 53.6% in this population.
鼻窦炎是儿童期非常常见的疾病。儿童鼻窦炎的临床表现与成人不同。泰国关于儿童鼻窦炎的信息有限。我们进行了一项前瞻性描述性研究，以确定泰国儿童鼻窦炎的临床特征。
招募了100名在儿科过敏诊所、儿科门诊和儿科耳鼻喉科诊所就诊且临床诊断为鼻窦炎的儿科患者。临床诊断依据前鼻镜检查发现中鼻道有脓性分泌物且伴有上呼吸道感染症状来确定。进行了详细的病史采集和体格检查，并将结果记录在鼻窦炎问卷中。77名患者进行了鼻窦X光检查，由一名对患者临床情况不知情的放射科医生进行盲法阅片。用一组泰国常见的气传变应原进行了变应原皮肤点刺试验。
100名患者的年龄范围在1.7至12.4岁之间，平均（±标准差）为6±2.72岁。患者及其家庭中特应性疾病史阳性率分别为49%和47%。四种最常见的临床表现为流涕（95%）、夜间及脓性咳嗽（91%）、鼻塞（74%）和鼻后滴漏（66%）。三种最常见的体征为中鼻道阻塞（100%）、鼻甲肿胀（92%）和咽部颗粒样改变（48%）。所有鼻窦X光片均异常，其中上颌窦是最常受累的鼻窦（99%），其次是筛窦（91%）。大多数患者累及多个鼻窦。皮肤点刺试验阳性率为53.6%。两种最常见的致敏变应原是尘螨（57.7%）和蟑螂（18.6%）。
流涕、咳嗽、鼻塞和鼻后滴漏症状的出现应提醒医生对儿科患者进行鼻窦炎的诊断。上颌窦和筛窦是最常受累的鼻窦。该人群中高达53.6%存在特应性易感性。
