Ramadan Hassan H, Makary Chadi A
Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown West Virginia, USA.
Am J Rhinol Allergy. 2014 Jan-Feb;28(1):e80-2. doi: 10.2500/ajra.2014.28.4004.
Chronic adenoiditis (CA) and chronic rhinosinusitis (CRS) in children are difficult to distinguish based on symptoms alone. A computed tomography (CT) scan is one way to distinguish between the two entities. The purpose of this study was to determine whether CT scores can predict outcome of adenoidectomy.
A retrospective review was performed over a 10-year period. All children who failed medical treatment had a CT scan and an adenoidectomy, which were reviewed. Children who had a CT score of ≥5 were included in the CA with concurrent CRS group, whereas those who had a CT score of <5 were included in the CA without CRS group.
Two hundred thirty-three children met the aforementioned criteria. Mean age was 5.5 years and mean CT score was 6.4. The CRS group had a success rate of 43%, whereas the CA group had a 65% success rate (p = 0.0017). Those children who were asthmatic and had CRS had a success rate of 28% compared with 53% for those who had CA (p = 0.022).
Making the diagnosis of CRS in children seems to be critical in determining whether, initially, an adenoidectomy alone is an appropriate treatment, specifically for those who have asthma.
儿童慢性腺样体炎（CA）和慢性鼻-鼻窦炎（CRS）仅根据症状很难区分。计算机断层扫描（CT）是区分这两种疾病的一种方法。本研究的目的是确定CT评分是否能预测腺样体切除术的结果。
进行了一项为期10年的回顾性研究。所有药物治疗失败的儿童均接受了CT扫描和腺样体切除术，并对其进行评估。CT评分≥5分的儿童被纳入合并CRS的CA组，而CT评分<5分的儿童被纳入不合并CRS的CA组。
233名儿童符合上述标准。平均年龄为5.5岁，平均CT评分为6.4分。CRS组的成功率为43%，而CA组的成功率为65%（p = 0.0017）。哮喘合并CRS的儿童成功率为28%，而CA儿童的成功率为53%（p = 0.022）。
对于儿童，诊断CRS对于确定最初仅行腺样体切除术是否为合适的治疗方法似乎至关重要，特别是对于患有哮喘的儿童。
