Surgery Department, Federal University of Pernambuco, Recife 50670-901, Brazil.
Agamenon Magalhães Hospital, Recife 52070-230, Brazil.
Viruses. 2021 Jan 5;13(1):62. doi: 10.3390/v13010062.
Upper respiratory obstruction is a common sequela in children with Zika-related microcephaly (ZRM). As a cross-sectional analysis nested in a cohort study, this study aims to investigate the prevalence of adenoid hypertrophy (AH) in children with ZRM and symptoms of respiratory obstruction. The data were collected in the first three years of life from children with ZRM who were followed in two reference centers for otorhinolaryngological care of patients with congenital Zika syndrome. Out of 92 children with confirmed ZRM, 57 were evaluated by nasopharyngoscopy after presenting with upper respiratory obstruction symptoms. In this study, 31 of the 57 (54%) children with ZRM who were evaluated had obstructive AH. Thirteen children with obstructive AH were submitted to surgery, which resulted in the complete resolution of symptoms for 11, partial resolution in 1, and no improvement in 1. No evidence of direct involvement by Zika virus (ZIKV) infection in the adenoid tissues was demonstrated by histology or immunohistochemistry. Our results suggest that there is a high prevalence and early presentation of AH in children with ZRM, with consequent upper airway obstruction causing upper airway obstructive disorder, secretory otitis media, and dysphagia.
上呼吸道梗阻是寨卡病毒相关小头畸形（ZRM）患儿的常见后遗症。本研究为队列研究中的病例对照研究，旨在调查伴有呼吸道梗阻症状的 ZRM 患儿腺样体肥大（AH）的发生率。研究数据来自于在两个先天性寨卡综合征患者耳鼻喉科护理的参考中心随访的 ZRM 患儿，收集了其生命最初 3 年的数据。在出现上呼吸道梗阻症状后，对 92 例确诊为 ZRM 的患儿中的 57 例行鼻咽镜检查。在评估的 57 例 ZRM 患儿中，有 31 例（54%）存在梗阻性 AH。13 例梗阻性 AH 患儿接受了手术治疗，其中 11 例症状完全缓解，1 例部分缓解，1 例无改善。组织学或免疫组化均未显示 ZIKV 感染直接累及腺样体组织。我们的研究结果表明，ZRM 患儿存在高发病率和早期出现的 AH，进而导致上气道梗阻，引起上气道梗阻性疾病、分泌性中耳炎和吞咽困难。
