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.
[1] 冯思聪,于晓岚,娄丹. 基于囊泡组织Ki67、GM-CSF表达评估Messerklinger中鼻甲成形术对慢性鼻-鼻窦炎合并鼻息肉的效果[J]. 山东大学耳鼻喉眼学报, 2026, 40(3): 31-39.
[2] 朱希倩,王佳,孙祖贤,冯建秀,张梦佳,赵颖,王宏,姜敏敏. 上海市杨浦区2022—2024年6~9岁学龄儿童屈光状态分析[J]. 山东大学耳鼻喉眼学报, 2026, 40(3): 102-109.
[3] 翟雪纯,边欣,陈敬彩,邓家钰,叶子,杨萍丽. 慢性额窦炎患者焦虑抑郁特点及横断面研究[J]. 山东大学耳鼻喉眼学报, 2026, 40(2): 35-43.
[4] 方璐, 雷玉丹, 王华. 环孢素滴眼液联合玻璃酸钠滴眼液治疗干眼临床效果的Meta分析[J]. 山东大学耳鼻喉眼学报, 2026, 40(2): 65-73.
[5] 雷玉丹,方璐,陈健,彭昌福. 托珠单抗治疗激素抵抗或不耐受的中重度甲状腺相关性眼病临床疗效的Meta分析[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 54-67.
[6] 朱明琼,李征,刘茹,田涛,彭婧利,吕倩怡,谭华霞. 基于OCT/OCTA的AI筛查系统在抗VEGF治疗糖尿病性黄斑水肿患者效果评价中的应用[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 68-73.
[7] 卢朝阳, 翟兆雪, 王慧康, 邵丽婷, 张宇. 新冠肺炎治疗引发糖尿病酮症酸中毒合并鼻眶脑型毛霉菌病1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 90-94.
[8] 顾敏,陆美萍. 纳米药物输送系统在变应性鼻炎过敏原免疫治疗中的应用进展[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 106-111.
[9] 程卓, 梁辉, 邢鲁民. 深度学习技术在咽喉内镜应用中的研究进展及前景分析[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 112-119.
[10] 刘一洁,卢秀珍,吴秋欣. 外泌体在眼病发病机制和诊疗中的研究进展[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 135-141.
[11] 马孝宝,沈佳丽,杨军,陈建勇,朱颂欢. 水平半规管扫视波的临床意义探究[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 40-45.
[12] 李阳松,袁发洋,杨艳,张田,喻国冻. 基于Web of Science进行生物制剂治疗慢性鼻窦炎文献计量学分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 54-64.
[13] 杜康丽,郑振宇,徐战将,张宇,陈露,卢梦垚. 鼻中隔偏曲并发慢性鼻窦炎风险预测模型的构建与验证[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 78-86.
[14] 刘梓琪,黄佳丽,汪李琴,陈曦,张立庆,周涵. 窄带成像内镜联合嗓音声学分析在声带白斑鉴别诊断中的价值[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 87-96.
[15] 刘玉柱,陈尧,苑铁君,李春森,李波. 喉纤维肉瘤1例并相关文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 133-137.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!