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Sinusitis and Eustachian tube dysfunction in children.

G Leo¹, E Piacentini, C Incorvaia

¹Pediatric Allergy and Respiratory Physiopathology Unit, Istituti Clinici di Perfezionamento, Milan, Italy. g.leo@icp.mi.it

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology

|December 6, 2007

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Middle ear dysfunction is common in children with chronic sinusitis, affecting nearly 70% of those diagnosed. Eustachian tube dysfunction rates decrease with age, independent of allergies.

Area of Science:

Otolaryngology
Pediatrics
Allergy Immunology

Background:

Middle ear disorders frequently co-occur with sinusitis due to shared anatomical and functional pathways.
The prevalence of Eustachian tube dysfunction (ETD) in pediatric chronic sinusitis is often underestimated.
Understanding the relationship between sinusitis, ETD, and respiratory allergy in children is crucial for effective management.

Purpose of the Study:

To evaluate the prevalence of Eustachian tube dysfunction in children diagnosed with chronic sinusitis.
To investigate the potential association between Eustachian tube dysfunction and respiratory allergy in this pediatric population.
To analyze the influence of age on the occurrence of Eustachian tube dysfunction in children with chronic sinusitis.

Main Methods:

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A cohort of 1810 children with chronic respiratory symptoms was screened.
Chronic sinusitis was diagnosed clinically in 402 children.
Eustachian tube function was assessed using tympanometry, and allergy status was determined via skin prick tests.

Main Results:

A high prevalence of chronic sinusitis (22.2%) was observed in the study population.
Altered middle ear pressure, indicative of ETD, was found in 69.1% of children with chronic sinusitis.
ETD rates were significantly higher in younger children (<6 years) (p=0.001).
Positive allergy skin tests were noted in 29.8% of children, with higher rates in older children (p=0.015).
Atopy did not appear to influence the occurrence of ETD.

Conclusions:

Eustachian tube dysfunction is highly prevalent in children with chronic sinusitis.
The age-related decrease in ETD suggests a role for upper airway anatomical development.
Respiratory allergy status does not seem to be a significant factor in the development of ETD in this context.