儿童慢性鼻窦炎的表型和内源性分型。

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY
Otolaryngology- Head and Neck Surgery Pub Date : 2025-07-01 Epub Date: 2025-03-20 DOI:10.1002/ohn.1231
Ella Morgan, Michael J Cunningham, Eelam A Adil
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引用次数: 0

摘要

目的:根据临床、影像学和实验室检查结果,将儿童慢性鼻窦炎(CRS)区分为临床相关的原发性和继发性表型。研究设计:回顾性分析5年内接受鼻窦内窥镜手术的CRS患者。环境:三级转诊儿童医院。方法:记录相关的病史和手术史,包括发病、临床和影像学表现、实验室资料和手术培养结果。数据分析结果,在适当的情况下,表型和内型表征。结果:94例患者符合纳入标准,年龄6.8 ~ 22.0岁,平均年龄15.4岁。嗜酸性CRS是最常见的主要表型(n = 19, 20.2%),该组最可能有复发性疾病,需要翻修手术。确定的其他主要表型包括过敏性真菌性鼻-鼻窦炎(n = 10, 10.6%)和中央室特应性疾病(n = 2, 2.1%)。伴有囊性纤维化的CRS是最常见的继发性CRS类型(n = 13, 13.8%)。根据现有数据,超过三分之一的患者(n = 36,38.2%)无法根据当前的临床和放射学标准归类为特定的表型。结论:成人CRS的表型和内型分类系统正在发展。本研究强调,这样的分类系统在儿童和青少年年龄组是可能的,促进针对潜在炎症机制的靶向生物治疗。鉴于在大约三分之一的患者中无法确定鼻窦炎的病因,显然需要进一步的调查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Phenotyping and Endotyping Pediatric Chronic Rhinosinusitis.

Objective: To differentiate pediatric chronic rhinosinusitis (CRS) into clinically relevant primary and secondary phenotypes based on clinical, radiographic, and laboratory findings.

Study design: Retrospective chart review of patients with CRS who underwent endoscopic sinus surgery over a 5-year period.

Setting: Tertiary referral children's hospital.

Methods: Relevant medical and surgical history inclusive of disease onset, clinical and radiographic findings, laboratory data, and operative culture results was recorded. Data analysis resulted, where appropriate, in phenotype and endotype characterization.

Results: In total, 94 patients, aged 6.8 to 22.0 years, with a mean age of 15.4 years, satisfied the inclusion criteria. Eosinophilic CRS was the most common primary phenotype (n = 19, 20.2%), and this group was the most likely to have recurrent disease requiring revision surgery. Additional primary phenotypes identified included allergic fungal rhinosinsusitis (n = 10, 10.6%) and central compartment atopic disease (n = 2, 2.1%). CRS associated with cystic fibrosis was the most common secondary CRS category (n = 13, 13.8%). Based on available data, over one-third of patients (n = 36, 38.2%) could not be categorized into a specific phenotype based on current clinical and radiologic criteria.

Conclusion: A phenotype and endotype-based classification system for CRS is evolving for the adult population. This study highlights that such a classification system is possible in the pediatric and adolescent age group, facilitating targeted biologic therapies at the underlying inflammatory mechanism. Further investigation is clearly required given an etiologic source of paranasal sinus inflammation could not be identified in approximately one-third of patients.

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来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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