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Paying attention to the 'lateral airway' allergic diseases in children
Journal of Otolaryngology and Ophthalmology of Shandong University
2019, 33 (1):
59-62.
DOI: 10.6040/j.issn.1673-3770.1.2018.042
Allergic diseases are autoimmune diseases that involve multi-organ systems producing a variety of clinical manifestations; concurrently, there is an intrinsic and inseparable link between multiple systems and clinical manifestations, producing a variety of manifestations among different age-groups and populations. Focusing on allergic diseases that are associated with the respiratory airway in children is relatively complicated due to the dynamic changes observed with respect to their body structures and immune systems. Allergic rhinitis, allergic asthma, and otitis media with effusion are three examples of allergic respiratory diseases in children that affect the same airway at different anatomical regions, and the correlation between them is receiving greater attention. Whether the upper, lower, and lateral airways could ever truly be in concurrence with each other is worth an in-depth discussion, and thus, we put forward some minor thoughts and suggestions based on the available clinical research and literature.
Fig.2
The left one provides an illustration of "Integration of upper and lower airways". If we add our "lateral airway" into the regular pattern, we'll end up with the following updated diagram calling "Integration of upper, lower and lateral airways"
Extracts from the Article
综上所述,对于OME与AR相关性的共识大于争议,目前已形成了大部分儿童OME患者存在过敏体质的理念;证实了中耳腔内具有Th2型过敏反应所需的中间介质;临床证据证明了“中耳黏膜是可以直接或者间接发生过敏反应的黏膜系统”;对OME抗过敏治疗是有效的,可减少手术。而关于过敏性炎症是分泌性中耳炎的危险因素的机制以及对复发性分泌性中耳炎抗过敏治疗是否可行仍需多中心和大样本的深入研究。我们认为应该重视儿童“侧呼吸道过敏性炎症”,将呼吸道过敏性炎症疾病补充为“上、下和侧呼吸道过敏性炎症一体化”的概念或许会更加合理(图2),这一观点值得我们进一步探讨和完善。
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