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21三体综合征患儿的耳鼻喉科特征:墨西哥费德里科·戈麦斯儿童医院171例患者的研究

Características otorrinolaringológicas en niños con trisomía 21: un estudio de 171 pacientes en el Hospital Infantil de México Federico Gómez.

作者信息

Peraza Natalia, Torre Carlos De La, Álvarez Alicia, Villamor Perla

机构信息

Servicio de Otorrinolaringología Pediátrica, Hospital Infantil de México Federico Gómez, Ciudad de México, México.

出版信息

Bol Med Hosp Infant Mex. 2019;76(2):87-94. doi: 10.24875/BMHIM.19000124.

Abstract

INTRODUCTION

Children with trisomy 21 face a wide range of conditions in the head and neck region, for which it is important that physicians are aware and have a strong understanding of the ear, nose, and throat (ENT) disorders, and their management as well.

METHODS

Retrospective case series of pediatric patients with trisomy 21. The spectrum of otolaryngological manifestations, their management, and outcomes of each case were analysed.

RESULTS

One hundred and seventeen pediatric patients were included. The mean age was 7.2 ± 4.2 years. More than half of the patients (63%) had hearing loss (HL). The most frequent presentation was conductive HL, predominating the mild and bilateral type. The most common otological manifestations found were external ear canal stenosis and Eustachian tube dysfunction. Up to 75% of the patients with otologic involvement required some surgical procedure. The most common rhinological manifestations were chronic rhinosinusitis and allergic rhinitis. Obstructive sleep apnea (OSA) was present in 30% of all patients, which main treatment was tonsillectomy, followed by continuous positive and biphasic positive airway pressure treatments. Less than 5% of the patients presented a laryngeal compromise.

CONCLUSIONS

Pediatric patients with trisomy 21 systematically should be referred to periodic ENT assessment due to the high incidence of manifestations in this region. Timely treatments should be offered in order to improve the health and the quality of life of the patient.

摘要

引言

21三体综合征患儿面临头颈部多种病症,因此医生了解并深入认识耳鼻喉(ENT)疾病及其治疗方法非常重要。

方法

对21三体综合征儿科患者进行回顾性病例系列研究。分析了耳鼻喉科表现的范围、治疗方法及每个病例的结果。

结果

纳入117例儿科患者。平均年龄为7.2±4.2岁。超过半数患者(63%)有听力损失(HL)。最常见的表现是传导性HL,以轻度和双侧型为主。发现的最常见耳科表现是外耳道狭窄和咽鼓管功能障碍。高达75%的耳科受累患者需要某种外科手术。最常见的鼻科表现是慢性鼻-鼻窦炎和变应性鼻炎。30%的患者存在阻塞性睡眠呼吸暂停(OSA),主要治疗方法是扁桃体切除术,其次是持续气道正压通气和双水平气道正压通气治疗。不到5%的患者存在喉部功能障碍。

结论

由于该区域病症发生率高,21三体综合征儿科患者应定期接受耳鼻喉科评估。应提供及时治疗,以改善患者的健康状况和生活质量。

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