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儿童和成人的后鼻孔息肉:一家三级护理医院的10年经验。

Choanal polyps in children and adults: 10-year experience from a tertiary care hospital.

作者信息

Perić Aleksandar, Vukadinović Tijana, Kujundžić Tarik, Labus Milica, Stoiljkov Marko, Đurđević Biserka Vukomanović

机构信息

Department of Otorhinolaryngology, Military Medical Academy Faculty of Medicine, Crnotravska 17, Belgrade, 11000, Serbia.

Department of Otorhinolaryngology, Clinical Centre of Montenegro, Podgorica, Montenegro.

出版信息

Eur Arch Otorhinolaryngol. 2019 Jan;276(1):107-113. doi: 10.1007/s00405-018-5208-9. Epub 2018 Nov 14.

Abstract

PURPOSE

Choanal polyps (CPs) are benign, solitary, soft-tissue lesions extending towards the junction between the nasal cavity and the nasopharynx through the choana. The aim of this retrospective study was to evaluate clinical and histological characteristics of CPs in children comparing to adult patients.

METHODS

Characteristics of CPs treated in our hospital (demography, main complaints, side, localization, surgical approach, histological characteristics, accompanying paranasal sinus diseases, association with allergic rhinitis, postoperative follow-up period, and recurrence rates) were retrospectively reviewed.

RESULTS

Seventy-eight patients with CPs were included, 22 (28%) patients in children and 56 (72%) patients in adults. We found no differences in the prevalence of main nasal complaints (nasal obstruction, rhinorrhea, snoring, and epistaxis) between the child and adult. In 27% children and in 7% adults, we found the oropharyngeal extension of CPs (p < 0.01). In 18% children and in 5.3% adults, we found the histological characteristics of an angiomatous CP (p < 0.05). The association with allergic rhinitis was more frequent in children (32%) than in adults (18%) (p < 0.05). In 32% pediatric patients and in 14% adult patients, we found the association with ipsilateral chronic maxillary rhinosinusitis without nasal polyps (CRSsNP) (p < 0.05). After the surgical treatment, we found the recurrence in 3 (14%) pediatric and in 5 (8%) adult patients, without the significant difference.

CONCLUSION

Our results suggest some specificities of CPs in children comparing to adults. Oropharyngeal extension, association with allergic rhinitis and ipsilateral CRS, and the presence of angiomatous histological type of CPs are more frequent in the pediatric population.

摘要

目的

后鼻孔息肉(CPs)是一种良性、孤立的软组织病变,通过后鼻孔向鼻腔和鼻咽交界处延伸。本回顾性研究的目的是评估儿童CPs与成人患者相比的临床和组织学特征。

方法

回顾性分析我院治疗的CPs患者的特征(人口统计学、主要症状、患侧、部位、手术方式、组织学特征、伴发的鼻窦疾病、与变应性鼻炎的关联、术后随访时间和复发率)。

结果

共纳入78例CPs患者,其中儿童22例(28%),成人56例(72%)。我们发现儿童和成人主要鼻部症状(鼻塞、流涕、打鼾和鼻出血)的发生率没有差异。在27%的儿童和7%的成人中,我们发现CPs有口咽延伸(p < 0.01)。在18%的儿童和5.3%的成人中,我们发现了血管瘤样CPs的组织学特征(p < 0.05)。与变应性鼻炎的关联在儿童中(32%)比在成人中(18%)更常见(p < 0.05)。在32%的儿科患者和14%的成人患者中,我们发现与同侧无鼻息肉的慢性上颌窦炎(CRSsNP)有关联(p < 0.05)。手术治疗后,我们发现3例(14%)儿科患者和5例(约8%)成人患者复发,无显著差异。

结论

我们的结果表明,与成人相比,儿童CPs有一些特殊性。口咽延伸、与变应性鼻炎和同侧CRS的关联以及血管瘤样组织学类型的CPs在儿童人群中更常见。

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