山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (6): 16-19.doi: 10.6040/j.issn.1673-3770.0.2019.057

• • 上一篇    下一篇

儿童鼻窦炎的临床诊疗进展

李华斌,曹玉洁   

  1. 复旦大学附属眼耳鼻喉科医院耳鼻喉科, 上海 200031
  • 出版日期:2019-11-20 发布日期:2019-12-23

Diagnosis and treatment of pediatric rhinosinusitis

LI Huabin, CAO Yujie   

  1. Department of Otorhinolaryngology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai 200031, China
  • Online:2019-11-20 Published:2019-12-23

摘要: 儿童鼻窦发育和免疫能力均不够成熟,鼻窦炎临床特征和转归与成人患者差异显著,且与其他气道病变如变应性鼻炎、腺样体肥大及分泌性中耳炎及扁桃体炎、支气管哮喘等之间存在密切联系,容易出现眶内及颅内并发症,需要引起重视。论文主要讨论儿童慢性鼻窦炎的发病机制、诊断及诊疗进展,重点对药物治疗和手术治疗进行阐述,希冀对耳鼻喉科医生诊疗此类儿童疾病提供参考。

关键词: 儿童, 鼻窦炎, 抗生素, 诊断, 治疗

Abstract: Pediatric rhinosinusitis has distinctly different clinical characteristics and outcomes compared to rhinosinusitis in adults. This is due to the immature development of the paranasal sinuses and immune system. Pediatric rhinosinusitis and other airway diseases, such as allergic rhinitis, otitis media, tonsillitis, and asthma, are closely related. Additionally, patients with pediatric rhinosinusitis are at risk of developing orbital and intracranial complications. Therefore, pediatric rhinosinusitis deserves great attention. This article discusses the pathogenesis, diagnosis, and treatment of chronic rhinosinusitis in children as well as the medication and surgical treatment options.

Key words: Children, Rhinosinusitis, Antibiotics, Diagnosis, Treatment

中图分类号: 

  • R765
[1] 闫淯淳, 吴朔春, 袁新宇, 等. 儿童鼻窦正常气化规律初探[J]. 中华耳鼻咽喉头颈外科杂志, 2011, 46(8): 650-653. doi: 10.3760/cma.j.issn.1673-0860. 2011.08.008. YAN Yuchun, WU Shuochun, YUAN Xinyu, et al. Preliminary study on normal aerification of paranasal sinuses in children[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2011, 46(8): 650-653. doi:10.3760/cma.j.issn.1673-0860. 2011.08.008.
[2] Slavin RG, Spector SL, Bernstein IL, et al. The diagnosis and management of sinusitis: a practice parameter update[J]. J Allergy Clin Immunol, 2005, 116(6 Suppl): S13-S47. doi: 10.1016/j.jaci. 2005.09.048.
[3] Wagenmann M, Naclerio RM. Complications of sinusitis[J]. J Allergy Clin Immunol, 1992, 90(3 Pt 2): 552-554. doi: 10.1016/0091-6749(92)90184-4.
[4] Brook I. Acute sinusitis in children[J]. Pediatr Clin North Am, 2013, 60(2): 409-424. doi:10.1016/j.pcl. 2012.12.002.
[5] Magit A. Pediatric rhinosinusitis[J]. Otolaryngol Clin North Am, 2014, 47(5): 733-746. doi:10.1016/j.otc. 2014.06.003.
[6] Heath J, Hartzell L, Putt C, et al. Chronic rhinosinusitis in children: pathophysiology, evaluation, and medical management[J]. Curr Allergy Asthma Rep, 2018, 18(7): 37. doi: 10.1007/s11882-018-0792-8.
[7] Wald ER, Applegate KE, Bordley C, et al. Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children aged 1 to 18 years[J]. Pediatrics, 2013, 132(1): e262-e280. doi:10.1542/peds. 2013-1071.
[8] Chandler JR, Langenbrunner DJ, Stevens ER. The pathogenesis of orbital complications in acute sinusitis[J]. Laryngoscope, 1970, 80(9): 1414-1428. doi:10.1288/00005537-197009000-00007.
[9] Shaikh N, Wald ER. Decongestants, antihistamines and nasal irrigation for acute sinusitis in children[J]. Cochrane Database Syst Rev, 2014(10): CD007909. doi:10.1002/14651858. CD007909. pub4.
[10] 许庚, 史剑波, 文卫平. 儿童鼻窦炎规范化诊断和治疗[J]. 中国耳鼻咽喉头颈外科, 2005, 12(7): 407-410. doi:10.3969/j.issn.1672-7002. 2005.07.001.
[11] Belcher R, Virgin F. The role of the adenoids in pediatric chronic rhinosinusitis[J]. Med Sci(Basel), 2019, 7(2): E35. doi: 10.3390/medsci7020035.
[12] Brietzke SE, Shin JJ, Choi S, et al. Clinical Consensus Statement[J]. Otolaryngol Head Neck Surg, 2014, 151(4): 542-553. doi:10.1177/0194599814549302.
[13] Lieser JD, Derkay CS. Pediatric sinusitis: when do we operate?[J]. Curr Opin Otolaryngol Head Neck Surg, 2005, 13(1): 60-66. doi: 10.1097/00020840-200502000-00014.
[14] Fokkens WJ, Lund VJ, Mullol J, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2012[J]. Rhinol Suppl, 2012, 23:3, 1-298.
[15] Bhattacharyya N, Jones DT, Hill M, et al. The diagnostic accuracy of computed tomography in pediatric chronic rhinosinusitis[J]. Arch Otolaryngol Head Neck Surg, 2004, 130(9): 1029-1032. doi:10.1001/archotol. 130.9. 1029.
[16] Brook I. The role of antibiotics in pediatric chronic rhinosinusitis[J]. Laryngoscope Investig Otolaryngol, 2017, 2(3): 104-108. doi: 10.1002/lio2.67.
[17] Ozturk F, Bakirtas A, Ileri F, et al. Efficacy and tolerability of systemic methylprednisolone in children and adolescents with chronic rhinosinusitis: a double-blind, placebo-controlled randomized trial[J]. J Allergy Clin Immunol, 2011, 128(2): 348-352. doi:10.1016/j.jaci. 2011.04.045.
[18] Brietzke SE, Brigger MT. Adenoidectomy outcomes in pediatric rhinosinusitis: a meta-analysis[J]. Int J Pediatr Otorhinolaryngol, 2008, 72(10): 1541-1545. doi:10.1016/j.ijporl. 2008.07.008.
[19] 许庚, 李源. 儿童慢性鼻窦炎手术治疗的思考与临床诊疗指引[J]. 中华耳鼻咽喉科杂志, 2003, 38(4): 241-242. doi: 10.3760/j.issn:1673-0860. 2003.04.001.
[20] Soler ZM, Rosenbloom JS, Skarada D, et al. Prospective, multicenter evaluation of balloon sinus dilation for treatment of pediatric chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2017, 7(3): 221-229. doi:10.1002/alr. 21889.
[21] Zalzal HG, Makary CA, Ramadan HH. Long-term effectiveness of balloon catheter sinuplasty in pediatric chronic maxillary sinusitis[J]. Ear Nose Throat J, 2019, 98(4): 207-211. doi:10.1177/0145561319840126.
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