Ear, Nose, and Throat Unit, Villa Montallegro Private Clinic, Genoa, Italy.
Am J Rhinol Allergy. 2013 Jan;27(1):e5-10. doi: 10.2500/ajra.2013.27.3854.
Nasal obstruction is a very common symptom in children. The main causes are allergic rhinitis (AR) and adenoidal hypertrophy (AH); the possible correlation between AR and AH has been investigated by few studies, mainly conducted using radiographic craniometry. This study aimed at investigating this topic by nasal endoscopy.
There were 205 children (134 boys; mean age, 6.7 years age range, 4-12 years) studied. Clinical visit, nasal endoscopy, and skin-prick test were performed in all patients. Anterior nasal obstruction was graded using the Friedmann's classification. Adenoid size was graded using the Parikh's classification. Perception of symptoms by children was also assessed using the visual analog scale.
Ninety-two children (44.9%) had complete nasal obstruction and 28 children (13.7%) had choanae invasion. There was a negative significant correlation (r = -0.41; p < 0.001) between nose obstruction severity and volume of adenoids. Decreased probability of greater adenoid volume was associated with increased severity of nose obstruction (odds ratio [OR] = 0.13) and in patients with allergy compared with nonallergic patients (OR = 0.31).
This real-life study shows that large adenoids may be associated with absence of allergy, whereas large turbinates may be associated with small adenoids.
鼻塞是儿童中非常常见的症状。主要原因是过敏性鼻炎（AR）和腺样体肥大（AH）；少数研究调查了 AR 和 AH 之间的可能相关性，主要通过颅射线照相术进行。本研究旨在通过鼻内窥镜检查来研究这个课题。
共研究了 205 名儿童（男 134 名；平均年龄 6.7 岁，年龄范围为 4-12 岁）。所有患者均进行临床检查、鼻内窥镜检查和皮肤点刺试验。采用 Friedmann 分级法对前鼻阻塞进行分级。采用 Parikh 分级法对腺样体大小进行分级。还使用视觉模拟量表评估儿童对症状的感知。
92 名儿童（44.9%）有完全性鼻塞，28 名儿童（13.7%）有后鼻孔阻塞。鼻阻塞严重程度与腺样体体积呈负显著相关（r = -0.41；p < 0.001）。腺样体体积增大的可能性降低与鼻阻塞严重程度增加（比值比 [OR] = 0.13）和过敏患者（OR = 0.31）相关。
这项真实世界的研究表明，大腺样体可能与无过敏有关，而大鼻甲可能与小腺样体有关。
