Pipolo C, Bianchini S, Barberi S, Landi M, D'Auria E, Fuccillo E, Gaffuri M, Marchisio P, Rosazza C, Saibene A M, Gelardi M, Torretta S
Otolaryngology Unit, Department of Health Sciences, ASST Santi Paolo e Carlo Hospital, Universita degli Studi di Milano, Milan, Italy.
Pediatric Highly Intensive Care Unit, Department of Maternal and Pediatric Sciences, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Universita degli Studi di Milano, Milan, Italy.
Rhinology. 2017 Sep 1;55(3):242-250. doi: 10.4193/Rhin16.287.
Nasal cytology has become a valuable tool in the assessment of a multitude of nasal pathologies in children. Collection methods differ significantly and even though the use of the nasal curette is regarded as the most reliable in adults, most practitioners use the nasal swab in children. However, no studies have validated the reliability and supposed better tolerability of the latter. We have compared these two sampling methods regarding their tolerability and analysed the diagnostic accuracy of the cotton nasal swab (NSW) to identify nasal cytotypes and rhinitis phenotypes, using nasal scraping (NSC) for comparison. In a multicentric prospective study we recruited 208 children and performed nasal cytology by means of NSW and NSC. Microscopic evaluating of the nasal cytotypes was performed and tolerability of NSW and NSC was tested. Our data revealed a significantly inferior diagnostic accuracy of NSW compared to NSC regarding reliability and cell counts. Our study is the first to shed light on the role of the sampling tools for pediatric nasal cytology. We documented a poor diagnostic accuracy of NSW, thus suggesting using only the nasal curette in clinical practice. Furthermore, tolerability did not differ between the two, refuting the common thesis that swabs are to be preferred when doing nasal cytology in children.
鼻细胞学检查已成为评估儿童多种鼻腔疾病的一项重要工具。采集方法差异显著，尽管鼻刮匙在成人中被认为是最可靠的，但大多数从业者在儿童中使用鼻拭子。然而，尚无研究证实后者的可靠性及所谓更好的耐受性。我们比较了这两种采样方法的耐受性，并分析了棉拭子鼻拭子（NSW）用于识别鼻细胞类型和鼻炎表型的诊断准确性，以鼻刮片（NSC）作为对照。在一项多中心前瞻性研究中，我们招募了208名儿童，通过NSW和NSC进行鼻细胞学检查。对鼻细胞类型进行显微镜评估，并测试NSW和NSC的耐受性。我们的数据显示，与NSC相比，NSW在可靠性和细胞计数方面的诊断准确性明显较差。我们的研究首次揭示了采样工具在儿童鼻细胞学检查中的作用。我们记录了NSW较差的诊断准确性，因此建议在临床实践中仅使用鼻刮匙。此外，两者的耐受性并无差异，这反驳了在儿童进行鼻细胞学检查时应首选拭子的普遍观点。
