山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (6): 29-33.doi: 10.6040/j.issn.1673-3770.1.2019.060

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儿童慢性鼻窦炎的外科治疗研究进展

刘佳,付勇   

  1. 浙江大学医学院附属儿童医院, 浙江 杭州 310051
  • 出版日期:2019-11-20 发布日期:2019-12-23

Advances in the surgical treatment of pediatric patients with chronic rhinosinusitis

LIU Jia, FU Yong   

  1. The Children Hospital Zhejiang University School of Medicine, Hangzhou 310051, Zhejiang, China
  • Online:2019-11-20 Published:2019-12-23

摘要: 近年来,儿童慢性鼻窦炎(CRS)越来越受到耳鼻咽喉科医生的重视。临床上,有一部分儿童CRS患者经过规范的药物治疗(不少于12周)后症状仍难以改善,甚至加重,或是经常复发,导致治疗失败。大量的临床实践表明,儿童鼻窦FESS手术可以取得比较满意的临床疗效,但仍有医师对儿童鼻窦FESS手术治疗存在质疑。鼻窦球囊扩张术治疗慢性鼻窦炎于2005年被引入耳鼻咽喉科。在过去的十几年里,有充分的证据支持它在治疗成人慢性鼻窦炎(CRS)方面的安全性和有效性。鼻窦球囊扩张术手术过程中不去除骨质,保留大部分或全部鼻窦黏膜,以极低的风险恢复鼻窦的通气,这样微创的方式适用于儿童。本文将对儿童慢性鼻窦炎外科治疗的相关研究进展做一综述。

关键词: 儿童慢性鼻窦炎, 鼻窦球囊扩张术, 功能性内窥镜鼻窦手术

Abstract: In recent years, increasing attention has been given by otolaryngology doctors to pediatric patients with chronic rhinosinusitis(CRS). Pediatric patients with CRS are often successfully managed using standard drug therapy of no less than 12 weeks. However, some pediatric patients with CRS suffer from frequent recurrences and treatmentfailure. Surgery is an option when medical management fails.However, the decision regarding surgical therapy inchildren is difficult.Balloon sinuplasty was introduced to otolaryngology in 2005 to treat nasal sinus inflammatory diseases. Evidence now strongly supports its safety and efficacy in treating chronic rhinosinusitis(CRS). As it requires no bone or tissue removal and retains most or all of the sinus mucosa, this procedure could be suitable for children.We will review the literature relating to the surgical treatment of chronic rhinosinusitis in children.

Key words: Pediatric patients with chronic rhinosinusitis, Balloon sinuplasty, Functional endoscopic sinus surgery

中图分类号: 

  • R765.04
[1] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组中国慢性鼻窦炎诊断和治疗指南(2018)[J]. 中华耳鼻咽喉头颈外科杂志, 2019, 54(2): 81-100. doi:10.3760/cma.j.issn.1673-0860. 2019. 02. 001.
[2] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组.儿童鼻窦炎诊断和治疗建议(2012)[J]. 中华耳鼻咽喉头颈外科杂志,2013,48(3):177-179.
[3] Jones NS. Acute and chronic sinusitis in children[J]. CurrOpinPulm Med, 2000, 6(3): 221-225. doi:10.1097/00063198-200005000-00010.
[4] 张亚梅,张天宇. 实用小儿耳鼻咽喉科学[M]. 人民卫生出版社. 2011, 275-285.
[5] 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.
[6] Smart BA, Slavin RG. Rhinosinusitis and pediatric asthma[J]. Immunol Allergy Clin North Am, 2005, 25(1): 67-82. doi:10.1016/j.iac. 2004.09.002.
[7] Cunningham MJ, Cunningham JM, Chiu EJ, et al. The health impact of chronic recurrent rhinosinusitis in children[J]. Arch Otolaryngol Head Neck Surg, 2000, 126(11): 1363-1368. doi:10.1001/archotol. 126.11.1363.
[8] Fokkens WJ, Lund VJ, Mullol J, et al. European position paper on rhinosinusitis and nasal polyps 2012[J].RhinolSuppl, 2012,(23): 1-298.
[9] Brietzke SE, Shin JJ, Choi S, et al. Clinical consensus statement: pediatric chronic rhinosinusitis[J]. Otolaryngol Head Neck Surg, 2014, 151(4): 542-553. doi:10.1177/0194599814549302.
[10] 陈扬, 付勇. 鼻腔冲洗在儿童鼻病治疗中的应用[J]. 中国中西医结合耳鼻咽喉科杂志, 2017, 25(3): 174-177. doi:10.16542/j.cnki.issn.1007-4856. 2017.03.005.
[11] Beswick DM, Messner AH, Hwang PH. Pediatric chronic rhinosinusitis management in rhinologists and pediatric otolaryngologists[J]. Ann OtolRhinolLaryngol, 2017, 126(9): 634-639. doi:10.1177/0003489417719717.
[12] Makary CA, Ramadan HH. The role of sinus surgery in children[J]. Laryngoscope, 2013, 123(6):1348-1352. doi:10.1002/lary. 23961.
[13] Gudis DA, Soler ZM. Update on pediatric sinus surgery: indications and outcomes[J]. Curr Opin Otolaryngol Head Neck Surg, 2017, 25(6): 486-492. doi:10.1097/MOO.0000000000000419.
[14] Zuliani G, Carron M, Gurrola J, et al. Identification of adenoid biofilms in chronic rhinosinusitis[J]. Int J Pediatr Otorhinolaryngol, 2006, 70(9): 1613-1617. doi:10.1016/j.ijporl. 2006.05.002.
[15] 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.
[16] Mair EA, Bolger WE, Breisch EA. Sinus and facial growth after pediatric endoscopic sinus surgery[J]. Arch Otolaryngol Head Neck Surg, 1995, 121(5): 547-552. doi:10.1001/archotol. 1995. 01890050041008.
[17] Hebert RL, Bent JP. Meta-analysis of outcomes of pediatric functional endoscopic sinus surgery[J]. Laryngoscope, 1998, 108(6): 796-799. doi:10.1097/00005537-199806000-00004.
[18] Catalano PJ. Balloon dilation technology: let the truth be told[J]. Curr Allergy Asthma Rep, 2013, 13(2): 250-254. doi:10.1007/s11882-012-0337-5.
[19] Levine H, Rabago D. Balloon sinuplasty: a minimally invasive option for patients with chronic rhinosinusitis[J]. Postgrad Med, 2011, 123(2): 112-118. doi:10.3810/pgm. 2011.03.2269.
[20] Thottam PJ, Metz CM, Kieu MC, et al. Functional endoscopic sinus surgery versus balloon sinuplasty with ethmoidectomy: A 2-year analysis in pediatric chronic rhinosinusitis[J]. Indian J Otolaryngol Head Neck Surg, 2016, 68(3): 300-306. doi:10.1007/s12070-015-0839-2.
[21] Koskinen A, Myller J, Mattila P, et al. Long-term follow-up after ESS and balloon sinuplasty: Comparison of symptom reduction and patient satisfaction[J]. Acta Otolaryngol, 2016, 136(5): 532-536. doi:10.3109/00016489. 2015. 1129553.
[22] Cazzavillan A, Castelnuovo P, Berlucchi M, et al. Management of chronic rhinosinusitis[J]. Pediatr Allergy Immunol, 2012, 23(Suppl 22): 32-44. doi:10.1111/j.1399-3038. 2012. 01322.x.
[23] Liu J, Zhao ZG, Chen Y, et al. Clinical curative effect and safety of balloon sinuplasty in children with chronic rhinosinusitis[J]. Int J Pediatr Otorhinolaryngol, 2017, 100: 204-210. doi:10.1016/j. ijporl. 2017.06.026.
[24] Koskinen A, Mattila P, Myller J, et al. Comparison of intra-operative characteristics and early post-operative outcomes between endoscopic sinus surgery and balloon sinuplasty[J]. Acta Otolaryngol, 2017, 137(2): 202-206. doi:10.1080/00016489. 2016.1227476.
[25] Sethi G, Chakravarti A. Quality of life after endoscopic sinus surgery in refractory pediatric chronic rhinosinusitis[J]. Int J Pediatr Otorhinolaryngol, 2016, 90: 160-164. doi:10.1016/j.ijporl. 2016.09.005.
[26] NogueiraJúnior JF, Stamm AC, Pignatari S. Balloon sinuplasty, an initial assessment: 10 cases, results and follow-up[J]. Braz J Otorhinolaryngol, 2010, 76(5): 588-595. doi: 10.1590/S1808-86942010000500009.
[27] Ramadan HH, Terrell AM. Balloon catheter sinuplasty and adenoidectomy in children with chronic rhinosinusitis[J]. Ann Otol Rhinol Laryngol, 2010, 119(9): 578-582. doi:10.1177/000348941011900902.
[28] Siedek V, Stelter K, Betz CS, et al. Functional endoscopic sinus surgery: a retrospective analysis of 115 children and adolescents with chronic rhinosinusitis[J]. Int J Pediatr Otorhinolaryngol, 2009, 73(5): 741-745. doi:10.1016/j.ijporl. 2009.01.019.
[29] Hauser LJ, Turner JH, Chandra RK. Trends in the use of stents and drug-eluting stents in sinus surgery[J]. Otolaryngol Clin North Am, 2017, 50(3): 565-571. doi:10.1016/j.otc. 2017.01.007.
[30] Campbell RG, Kennedy DW. What is new and promising with drug-eluting stents in sinus surgery?[J]. Curr Opin Otolaryngol Head Neck Surg, 2014, 22(1): 2-7. doi:10.1097/MOO.0000000000000012.
[31] Taulu R, Bizaki AJ, Numminen J, et al. A prospective, randomized clinical study comparing drug eluting stent therapy and intranasal corticoid steroid therapy in the treatment of patients with chronic rhinosinusitis[J]. Rhinology, 2017, 55(3): 218-226. doi:10. 4193/Rhin16. 070.
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