Klimek L, Chaker A, Matthias C, Sperl A, Gevaert P, Hellings P, Wollenberg B, Koennecke M, Hagemann J, Eckrich J, Becker S
Zentrum für Rhinologie und Allergologie Wiesbaden, An den Quellen 10, 65183, Wiesbaden, Deutschland.
Klinik für Hals-Nasen-Ohrenheilkunde und Zentrum für Allergie und Umwelt, Klinikum rechts der Isar, Technische Universität München, München, Deutschland.
HNO. 2019 Sep;67(9):715-730. doi: 10.1007/s00106-019-0719-2.
Chronic rhinosinusitis (CRS) is one of the most frequent chronic diseases. Among these patients the prevalence of immune defects is higher than in the healthy general population.
A selective review of the literature was carried out in PubMed and Medline covering the period between 2008 and 2019. Additionally, recent German publications in journals not listed in the abovementioned databases were analyzed.
The diagnostic workflow with respect to the immunodeficiency consists of a detailed anamnesis and physical examination, laboratory tests and the antibody reaction to polysaccharide vaccines and antigens. Beside antibiotic treatment, vaccinations and immunoglobulin replacement are available. Notwithstanding the above, functional endoscopic surgery of the paranasal sinuses should be performed according to guideline recommendations.
Patients with CRS who do not sufficiently respond to conservative and surgical treatment should be checked for underlying immunodeficiencies.
慢性鼻-鼻窦炎（CRS）是最常见的慢性疾病之一。在这些患者中，免疫缺陷的患病率高于健康普通人群。
在PubMed和Medline上对2008年至2019年期间的文献进行了选择性回顾。此外，还分析了上述数据库未列出的期刊中近期的德语出版物。
免疫缺陷的诊断流程包括详细的病史采集和体格检查、实验室检查以及对多糖疫苗和抗原的抗体反应。除抗生素治疗外，还可进行疫苗接种和免疫球蛋白替代治疗。尽管如此，鼻窦功能性内镜手术仍应根据指南建议进行。
对保守治疗和手术治疗反应不佳的CRS患者应检查是否存在潜在的免疫缺陷。
