Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, WV, USA.
School of Medicine, West Virginia University, Morgantown, WV, USA.
Int J Pediatr Otorhinolaryngol. 2024 Apr;179:111936. doi: 10.1016/j.ijporl.2024.111936. Epub 2024 Apr 3.
Studies in adult chronic rhinosinusitis (CRS) showed poor correlation between patient reported outcome measures (PROMs) and objective findings. Our goal is to study the correlation between the sinus and nasal quality of life (SN-5) and the 22-items sinonasal outcome test (SNOT-22) surveys with endoscopy findings in children with chronic adenoiditis (CA) and CRS.
Cross-sectional study of all pediatric patients (age 2-18) presenting for CA or CRS was performed. Patients and caregivers were asked to fill the SN-5 and SNOT-22 questionnaires at initial and follow up visits. Demographics and comorbidities were collected. Objective findings included endoscopy Modified Lund-Kennedy (MLK) scores and adenoid tissue size.
124 children were included, with mean age of 9.9 years (SD = 4.8) and 46.8% female. 36.3% had allergic rhinitis, 23.4% had asthma, and 4% had obstructive sleep apnea. Moderate correlation was found between the rhinologic domain of SNOT-22 and MLK scores (r = 0.36, p = 0.001) and between SN5 scores and adenoid size in all patients (r = 0.39, p < 0.001). SNOT-22 scores showed moderate correlation with adenoid size (r = 0.42, p < 0.001) more specifically in CA patients (r = 0.54, p < 0.001). The correlation of SN5 and MLK scores were higher in children with allergic rhinitis or asthma. The correlation between SN5 and adenoid size was lower in children with allergic rhinitis or asthma.
There is discrepancy between the subjective measures and the objective findings in children with CA or CRS. The physical exam findings may not reflect the effect of CRS on the quality of life of children.
成人慢性鼻-鼻窦炎（CRS）的研究表明，患者报告的结局测量（PROM）与客观发现之间相关性较差。我们的目标是研究儿童慢性腺样体炎（CA）和 CRS 患者的鼻窦和鼻腔生活质量（SN-5）和 22 项鼻-鼻窦结局测试（SNOT-22）调查与内镜检查结果之间的相关性。
对所有因 CA 或 CRS 就诊的儿科患者（年龄 2-18 岁）进行横断面研究。在初始和随访就诊时，患者及其照顾者被要求填写 SN-5 和 SNOT-22 问卷。收集人口统计学和合并症数据。客观发现包括内镜下改良 Lund-Kennedy（MLK）评分和腺样体组织大小。
共纳入 124 例儿童，平均年龄为 9.9 岁（标准差=4.8），女性占 46.8%。36.3%有过敏性鼻炎，23.4%有哮喘，4%有阻塞性睡眠呼吸暂停。SNOT-22 鼻科学领域与 MLK 评分之间存在中度相关性（r=0.36，p=0.001），SN5 评分与所有患者的腺样体大小之间存在中度相关性（r=0.39，p<0.001）。SNOT-22 评分与腺样体大小呈中度相关（r=0.42，p<0.001），在 CA 患者中更明显（r=0.54，p<0.001）。在患有过敏性鼻炎或哮喘的儿童中，SN5 和 MLK 评分之间的相关性更高。在患有过敏性鼻炎或哮喘的儿童中，SN5 与腺样体大小之间的相关性较低。
在患有 CA 或 CRS 的儿童中，主观测量与客观发现之间存在差异。体格检查结果可能无法反映 CRS 对儿童生活质量的影响。
