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原发性纤毛运动障碍患者的 ENT 表现:耳鼻喉科合并症的患病率和意义。

ENT manifestations in patients with primary ciliary dyskinesia: prevalence and significance of otorhinolaryngologic co-morbidities.

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.

出版信息

Eur Arch Otorhinolaryngol. 2011 Mar;268(3):383-8. doi: 10.1007/s00405-010-1341-9. Epub 2010 Jul 22.

DOI:10.1007/s00405-010-1341-9
PMID:20652291
Abstract

Primary ciliary dyskinesia (PCD) is a rare inherited disease with a prevalence of about 1:20,000. The underlying pathogenesis is disrupted ciliary function, which results in delayed mucus transportation leading to chronic inflammation, mainly in the upper and lower respiratory tract. Although the pathogenesis of the disease and its clinical presentation is somewhat understood, data regarding the prevalence of accompanying symptoms is limited, especially in the field of otorhinolaryngology. A total of 44 patients diagnosed with PCD answered a questionnaire regarding the diagnosis and clinical presentation of the disease, their medical history and clinical manifestations, and medical treatment in the field of otorhinolaryngology. The majority of participants (70%) had seen a physician more than 50 times before the diagnosis was made at an average age of 10.9 ± 14.4 years. As much as 59% of all patients had recurring problems at the paranasal sinuses and 69% of these patients needed corresponding surgical intervention. Even more patients (81%) suffered from recurring otitis media and, as a result, 78% of these patients underwent paracentesis with temporary tympanostomy tubes at least once at an average age of 9.5 ± 13.0 years. Otorhinolaryngologic symptoms, especially chronic otitis media and chronic rhinosinusitis, are frequently associated with PCD. Surgical intervention to treat these symptoms is common. The awareness of this disease should be raised, especially among ENT physicians, and surgical intervention should be indicated carefully.

摘要

原发性纤毛运动障碍(PCD)是一种罕见的遗传性疾病,患病率约为 1:20,000。其潜在的发病机制是纤毛功能障碍,导致黏液运输延迟,从而导致慢性炎症,主要发生在上呼吸道和下呼吸道。尽管该疾病的发病机制及其临床表现已有所了解,但关于伴随症状的患病率数据有限,特别是在耳鼻喉科领域。总共 44 名被诊断为 PCD 的患者回答了一份关于该疾病的诊断和临床表现、他们的病史和临床表现以及耳鼻喉科的治疗的问卷。大多数参与者(70%)在平均年龄为 10.9 ± 14.4 岁时被诊断出该疾病之前,已经看过医生超过 50 次。多达 59%的所有患者都有复发性鼻窦问题,其中 69%的患者需要相应的手术干预。更多的患者(81%)患有复发性中耳炎,因此,其中 78%的患者在平均年龄为 9.5 ± 13.0 岁时至少进行过一次鼓膜切开术和临时鼓膜置管。耳鼻喉科症状,尤其是慢性中耳炎和慢性鼻-鼻窦炎,常与 PCD 相关。治疗这些症状的手术干预很常见。应提高对这种疾病的认识,特别是在耳鼻喉科医生中,并且应谨慎指示手术干预。

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本文引用的文献

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Primary ciliary dyskinesia: a consensus statement on diagnostic and treatment approaches in children.原发性纤毛运动障碍:儿童诊断和治疗方法的共识声明。
Eur Respir J. 2009 Dec;34(6):1264-76. doi: 10.1183/09031936.00176608.
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[Primary ciliary dyskinesia (Pcd) in Austria].[奥地利的原发性纤毛运动障碍(Pcd)]
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Management of otitis media with effusion in children with primary ciliary dyskinesia: a literature review.原发性纤毛运动障碍患儿中耳积液的管理:文献综述
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A novel homozygous RSPH4A variant in a family with primary ciliary dyskinesia and literature review.一个原发性纤毛运动障碍家族中的新型纯合RSPH4A变异及文献综述
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Molecular defects in primary ciliary dyskinesia are associated with agenesis of the frontal and sphenoid paranasal sinuses and chronic rhinosinusitis.原发性纤毛运动障碍的分子缺陷与额窦和蝶窦鼻窦发育不全及慢性鼻窦炎相关。
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Ear and upper airway clinical outcome measures for use in primary ciliary dyskinesia research: a scoping review.原发性纤毛运动障碍研究中用于耳及上呼吸道的临床结局测量指标:范围综述。
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