Parsel Sean M, Riley Charles A, McCoul Edward D
Department of Otolaryngology-Head and Neck Surgery, Tulane University, New Orleans, LA.
Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York, NY.
Int Forum Allergy Rhinol. 2018 Mar 30. doi: 10.1002/alr.22123.
The impact of deployment to combat zones on the respiratory and sinonasal health of U.S. soldiers is an emerging public health concern. Retrospective studies have shown a correlation between deployment and development of post-deployment pathology, particularly of the aerodigestive system. Respiratory disease, including sinusitis, allergic rhinitis, and asthma, are commonly reported in soldiers deployed to the Middle East and Southwest Asia.
Current literature pertaining to combat zone exposure and development of respiratory disease was retrieved using PubMed, Embase, Web of Science, and Google Scholar.
Several types of combat zone exposures exist that may play an influential role in the development of upper and lower respiratory tract diseases. Exposures including foreign dusts, harsh environments, particulate size, and close living quarters may play a causative role. The effect of combat zone exposures has been better examined for lower respiratory tract diseases; however, with the theory of the unified airway, the upper respiratory tract may also be involved. There is evidence that the upper respiratory tract is susceptible, with an increased risk for development of sinusitis and sinonasal disease; however, the quality of evidence of the present literature is generally low.
More research is necessary to determine a pathophysiologic mechanism between combat zone exposure and the development of sinonasal disease. Practicing otolaryngologists should be aware of the possibility of combat zone exposures that could contribute to rhinologic symptomatology.
部署到作战区域对美国士兵呼吸和鼻窦健康的影响是一个新出现的公共卫生问题。回顾性研究表明，部署与部署后病理状况的发展之间存在关联，尤其是在气消化道系统方面。在部署到中东和西南亚的士兵中，呼吸系统疾病，包括鼻窦炎、过敏性鼻炎和哮喘，很常见。
使用PubMed、Embase、科学网和谷歌学术检索了与作战区域暴露和呼吸系统疾病发展相关的当前文献。
存在几种作战区域暴露类型，可能在上、下呼吸道疾病的发展中发挥重要作用。包括外来灰尘、恶劣环境、颗粒大小和居住空间狭小等暴露可能起致病作用。对于下呼吸道疾病，作战区域暴露的影响已得到更好的研究；然而，根据统一气道理论，上呼吸道也可能受到影响。有证据表明上呼吸道易受影响，鼻窦炎和鼻窦疾病的发病风险增加；然而，当前文献的证据质量普遍较低。
需要更多研究来确定作战区域暴露与鼻窦疾病发展之间的病理生理机制。执业耳鼻喉科医生应意识到作战区域暴露可能导致鼻科症状的可能性。
