鼻及鼻竇炎的共病症

Comorbidities of rhinosinusitis

張伯宏(Po-Hung Chang) ； 黃啟哲(Chi-Che Huang) ； 李達人(Ta-Jen Lee)

《台灣耳鼻喉頭頸外科雜誌》 55卷別冊 (2020/12) Pp. 43-50

https://doi.org/10.6286/jtohns.202012/SP_55.0006

摘要

慢性鼻及鼻竇炎之定義為鼻及鼻竇黏膜發炎超過3個月，其顯著影響病患的生活品質。鼻竇炎可能存在共病症，且對鼻竇炎的嚴重度及預後有所影響。其中最常見的，為過敏性鼻炎及下呼吸道疾病如氣喘。上下呼吸道為系統性統合呼吸道的觀念已經被廣為接受，臨床上氣喘的控制效果和鼻竇炎的嚴重度常呈現密切相關性，尤其罹患阿斯匹靈加重性呼吸道疾病時，易復發的鼻息肉對耳鼻喉科醫師也是極大的挑戰。過敏性鼻炎也是慢性鼻及鼻竇炎常見的共病症，兩者也都會影響下呼吸道疾病的控制，其中過敏有前文專文介紹。本文主要介紹以氣喘為主的下呼吸道疾病，以及臨床上常見的中耳積液，另以簡短篇幅描述其他台灣較為罕見的共病症如囊狀纖維化、先天免疫缺陷及原發性纖毛運動異常症。本文將介紹可能遇到的鼻竇炎共病症，並回顧國內外文獻，藉此希望臨床醫師能熟悉鼻竇炎的共病症。

關鍵字

allergy ； asthma ； cystic fibrosis ； immunodeficiency ； otitis media with effusion ； primary ciliary dyskinesia ； rhinosinusitis（過敏 ； 氣喘 ； 囊狀纖維化 ； 免疫缺陷 ； 積液性中耳炎 ； 先天性纖毛運動異常症 ； 鼻及鼻竇炎）

並列摘要

Chronic rhinosinusitis (CRS) is defined as inflammation of the sinonasal mucosa for more than 3 months. It has a great impact on patients' life quality. Some comorbid diseases can affect the severity and prognosis of CRS. The most common are allergic rhinitis and lower airway diseases such as asthma. The united airway theory has been widely accepted. The severity of CRS is closely correlated with asthma control clinically. Recurrent polyps in patients with aspirin-exacerbated respiratory disease frequently pose a challenge for otolaryngologists. Allergic rhinitis is also a common comorbid disease and also effects asthma control. Because allergic rhinitis was covered in another topic, this topic mainly mentioned about lower airway diseases including asthma. Middle ear effusion is also discussed here. In addition, cystic fibrosis, immunodeficiency and primary ciliary dyskinesia, which are relatively rare in Taiwan, are briefly mentioned. We review the literature on comorbidities of CRS that otolaryngologists may encounter.

並列關鍵字

allergy ； asthma ； cystic fibrosis ； immunodeficiency ； otitis media with effusion ； primary ciliary dyskinesia ； rhinosinusitis