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儿童腺样体疾病与慢性鼻-鼻窦炎——存在关联吗?

Adenoidal Disease and Chronic Rhinosinusitis in Children-Is there a Link?

作者信息

Bulfamante Antonio Mario, Saibene Alberto Maria, Felisati Giovanni, Rosso Cecilia, Pipolo Carlotta

机构信息

Otorhinolaryngology Unit, Department of Health Sciences, San Paolo Hospital, Università degli Studi di Milano, 20142 Milan, Italy.

Otorhinolaryngology Unit, San Paolo Hospital, 20142 Milan, Italy.

出版信息

J Clin Med. 2019 Sep 23;8(10):1528. doi: 10.3390/jcm8101528.

Abstract

Adenoid hypertrophy (AH) is an extremely common condition in the pediatric and adolescent populations that can lead to various medical conditions, including acute rhinosusitis, with a percentage of these progressing to chronic rhinosinusitis (CRS). The relationship between AH and pediatric CRS has been extensively studied over the past few years and clinical consensus on the treatment has now been reached, allowing this treatment to become the preferred clinical practice. The purpose of this study is to review existing literature and data on the relationship between AH and CRS and the options for treatment. A systematic literature review was performed using a search line for "(Adenoiditis or Adenoid Hypertrophy) and Sinusitis and (Pediatric or Children)". At the end of the evaluation, 36 complete texts were analyzed, 17 of which were considered eligible for the final study, dating from 1997 to 2018. The total population of children assessed in the various studies was of 2371. The studies were categorized as surgical-observational, microbiological, genetic-immunological, and radiological. The analysis of the studies confirms the relationship between AH and CRS and supports the existing consensus on medical and surgical therapy. Furthermore, these studies underline the necessity to adapt medical and surgical treatment considering age, comorbidities including asthma and, if present, the Computed Tomography (CT) score.

摘要

腺样体肥大(AH)在儿童和青少年群体中极为常见,可导致多种病症,包括急性鼻窦炎,其中一部分会进展为慢性鼻窦炎(CRS)。过去几年里,AH与小儿CRS之间的关系已得到广泛研究,目前在治疗方面已达成临床共识,使得这种治疗方法成为首选的临床实践。本研究的目的是回顾关于AH与CRS之间关系以及治疗选择的现有文献和数据。使用搜索词“(腺样体炎或腺样体肥大)和鼻窦炎以及(儿科或儿童)”进行了系统的文献综述。评估结束时,分析了36篇完整文本,其中17篇被认为符合最终研究的条件,时间跨度从1997年至2018年。各项研究中评估的儿童总数为2371名。这些研究分为手术观察性、微生物学、遗传免疫学和放射学研究。对这些研究的分析证实了AH与CRS之间的关系,并支持了关于药物和手术治疗的现有共识。此外,这些研究强调了根据年龄、合并症(包括哮喘)以及(如有)计算机断层扫描(CT)评分来调整药物和手术治疗的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be98/6832509/b7f0cef41747/jcm-08-01528-g001.jpg

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