Yang Liu, Tang Dezheng, Duan Chuanxin, Liao Dahong
Department of Otorhinolaryngology, Hubei Maternal and Child Hospital, Wuhan, 430071, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2007 Sep;21(17):779-81.
To evaluate clinical and imaging character of chronic rhinosinusitis in the children with chronic cough and to discuss the treatment of them.
Fifty-three children with chronic cough were examined by otolaryngologists and evaluated by computed tomography (CT) scan. Some of them were also evaluated by nasal endoscope. There was not any finding of lung in chest X-ray in Adhese children and children with immunodeficiency were ruled out from the study. The children with chronic sinusitis were treated according to general protocols for 6 to 8 weeks, among them those with adenoid vegetation accepted adenoidectomy.
Forty-three cases of 53 children with chronic cough, aged from 2 years and 10 months to 13 years old (average 7 years old), were proved with sinusitis by CT. The main symptom of them was chronic cough. Thirty-five cases of these 43 children were with purulence, among them, 8 cases with mucoid in middle meatus, 28 cases with folliculosis in posterior oropharynx, and 6 children with adenoid vegetation. Clinical stage of 19 cases of 53 children were belonged to I type 3 stage, 19 cases belonged to I type 2 stage, 5 cases belonged to I type 1 stage. The maxillary sinus was most frequently involved, followed by the ethmoid sinus, the frontal sinus, the sphenoid sinus. All of the 43 children with sinusitis accepted treatment for 6 to 8 weeks. After treatment, 81.4% of patients were fully recovered, 18.6% significantly improved, 4 with adenoidectomy and 2 with tympanostomy tubes.
The relationship between chronic sinusitis and chronic cough in children was closer than that in adults. It is very easy to make misdiagnosis because of other symptoms.
评估慢性咳嗽儿童慢性鼻窦炎的临床及影像学特征,并探讨其治疗方法。
53例慢性咳嗽儿童由耳鼻喉科医生进行检查,并接受计算机断层扫描(CT)评估。部分患儿还接受了鼻内镜检查。粘连患儿胸部X线检查未发现肺部异常,免疫缺陷患儿被排除在研究之外。慢性鼻窦炎患儿按照常规方案治疗6至8周,其中腺样体肥大患儿接受腺样体切除术。
53例慢性咳嗽儿童中,43例年龄在2岁10个月至13岁之间(平均7岁),经CT证实患有鼻窦炎。其主要症状为慢性咳嗽。这43例患儿中35例有脓性分泌物,其中8例中鼻道有黏液,28例咽后壁有滤泡,6例有腺样体肥大。53例患儿中19例临床分期为Ⅰ型3期,19例为Ⅰ型2期,5例为Ⅰ型1期。上颌窦受累最常见,其次是筛窦、额窦、蝶窦。43例鼻窦炎患儿均接受了6至8周的治疗。治疗后,81.4%的患者完全康复,18.6%明显改善,4例行腺样体切除术,2例行鼓膜置管术。
儿童慢性鼻窦炎与慢性咳嗽的关系比成人更为密切。因其他症状很容易造成误诊。