Arjun Sharma, Lana Mamoun, Nihal Punjabi, Roy Qu, Joseph D. Peterson, Jared C. Inman
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引用次数: 0
摘要
目的:更好地阐明小儿鼻中隔穿孔的病因、症状和手术修复效果。研究设计:系统评价和荟萃分析。方法:使用“鼻中隔”、“穿孔”、“儿科”和所有相关同义词查询PubMed、Embase和Web of Science图书馆。所有包括0-18岁患者鼻中隔穿孔及其病因的研究均被纳入。结果:在回顾了498项研究后,9项回顾性研究纳入了219例患者进行初步分析。文献中鼻中隔穿孔最常见的病因是医源性(34.25%)、外伤性(23.29%)和特发性(18.26%)。报告最多的症状是结痂、鼻出血和鼻塞。手术修复的总闭合率为0.86 [95% CI 0.76-0.95;i2 = 17%]。在自身免疫、药物和异物相关病因的患者中,闭合率明显较低。穿孔大小与闭合成功之间没有明确的关系。结论:总的来说,小儿鼻中隔穿孔似乎主要是由医源性和外伤性病因引起的。儿科患者也有很高比例的异物相关缺陷。小儿鼻中隔穿孔的闭合率仍然很高。
To better elucidate the aetiologies, symptomatology, and surgical repair outcomes for nasal septal perforations in the paediatric population.
Study Design
Systematic review and meta-analysis.
Methods
The PubMed, Embase and Web of Science libraries were queried using the terms “nasal septum,” “perforation,” and “paediatric” and all relevant synonyms. All studies that included data on nasal septal perforations in patients aged 0–18 and their etiologies were included.
Results
After 498 studies were reviewed, 9 retrospective studies with 219 patients were included for the primary analysis. The most common etiologies for nasal septal perforations in the literature were iatrogenic (34.25%), traumatic (23.29%), and idiopathic (18.26%). The most reported symptoms were crusting, epistaxis, and nasal obstruction. The overall closure rate for surgical repair was 0.86 [95% CI 0.76–0.95; I2 = 17%]. Closure rates were notably lower in patients with autoimmune, drug, and foreign body related etiologies. There was no clear relationship between perforation size and closure success.
Conclusion
Overall, paediatric nasal septal perforations appear to primarily be caused by iatrogenic and traumatic etiologies. Paediatric patients also experience high proportions of foreign body-related defects. Closure rates remain high for paediatric patients with nasal septal perforations.
期刊介绍:
Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with:
current otorhinolaryngological practice
audiology, otology, balance, rhinology, larynx, voice and paediatric ORL
head and neck oncology
head and neck plastic and reconstructive surgery
continuing medical education and ORL training
The emphasis is on high quality new work in the clinical field and on fresh, original research.
Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject.
• Negative/null results
In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.