摘要
兒童慢性鼻及鼻竇炎的盛行率大約為2.1%－4%。好發年齡為10－15歲。兒童鼻及鼻竇炎之發生與遺傳有關，但鼻息肉的產生則與環境因素與遺傳因素都有關。不論抽菸或是暴露於二手菸都會增加兒童鼻及鼻竇炎的發生。腺樣體對兒童慢性鼻及鼻竇炎的影響來自所含的細菌，而非機械性的阻塞。過敏性鼻炎是否會導致與兒童慢性鼻及鼻竇炎目前仍無定論，而胃食道逆流與兒童慢性鼻及鼻竇炎的相關性也仍未有定論。另外免疫功能不佳以及囊腫性纖維化等疾病都有可能相關。兒童鼻及鼻竇炎的治療以藥物為優先。類固醇鼻噴劑可用於兒童慢性鼻及鼻竇炎的第一線治療。生理食鹽水鼻腔沖洗不論是單獨使用或是配合其他藥物或手術治療都可以改善兒童慢性鼻及鼻竇炎的症狀。當藥物治療無效或是嚴重急性鼻及鼻竇炎的併發症時會考慮手術治療。12歲以下兒童慢性鼻及鼻竇炎藥物治療失敗後，腺樣體切除手術可作為的第一線外科手術的選擇。不論有無伴隨鼻息肉，兒童慢性鼻及鼻竇炎在接受功能性內視鏡鼻竇手術後生活品質都可以明顯改善。
並列摘要
The prevalence of pediatric chronic rhinosinusitis (PCRS) is about 2.1% to 4%. The 10-15 year-old age groups are most affected. Significant familial risk is associated with PCRS but environmental factors are as likely as genetic ones to influence the occurrence of nasal polyps. Both passive and active cigarette smoking are associated with PCRS. The adenoids may act as a reservoir for pathogenic bacteria, rather than a source of obstruction. A definitive causal relationship between allergic rhinitis and PCRS has not been established and the relationship between gastroesophageal reflux disease and PCRS remains controversial. Associated immunodeficiency and cystic fibrosis should be considered. Medical therapy remains the mainstay of management of PCRS. Intranasal steroids are recommended. Saline nasal irrigation can improve the symptoms of PCRS, whether used alone or in combination with other drugs or surgical treatment. Surgical intervention is considered for patients with CRS who have failed appropriate medical therapy or suffered from complications of severe acute rhinosinusitis. Adenoidectomy can be used as the first-line surgical option in PCRS children under 12 years old. Functional endoscopic sinus surgery can improve the quality of life whether polyposis is associated with PCRS.
延伸閱讀
- 方端仁、林新景、張伯宏（2007）。兒童鼻及鼻竇炎。台灣耳鼻喉頭頸外科雜誌，42()，40-47。https://doi.org/10.6286/2007.42.s_1.40
- 蕭宏榮、黃弘孟、趙敏政、陳玉林（1997）。小兒慢性鼻竇炎之細菌學。中華民國耳鼻喉科醫學會雜誌，32(2)，116-120。https://doi.org/10.6286/1997.32.2.116
- 徐茂銘（1977）。慢性鼻竇炎。當代醫學，(46)，729-730。https://doi.org/10.29941/MT.197708.0006
- 張世倫（2016）。急性鼻竇炎。奇美醫訊，(115)，30-31。https://www.airitilibrary.com/Article/Detail?DocID=P20180523001-201612-201805240020-201805240020-30-31
- 王凌峰、戴志峰（2020）。Medical Treatment of Chronic Rhinosinusitis: Others。台灣耳鼻喉頭頸外科雜誌，55()，78-84。https://doi.org/10.6286/jtohns.202012/SP_55.0011