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[Age features of the lower nasal passage according to endoscopy in children]
K K Baranov1, M R Bogomilsky1, E N Kotova1
1Pirogov Russian National Research Medical University, Moscow, Russia.
Objective:
To study the anatomical features of the lower nasal passage in children in the age aspect by analyzing the results of endoscopic examination of the nasal cavity.
Material And Methods:
The study included 377 children who did not have otorhinolaryngological and ophthalmological pathologies, as well as congenital anomalies in the architectonics of the nose. The distribution into 4 groups, depending on age, was carried out according to the main provisions of the classification of childhood periods by N.P. Gundobin: the first group - children under 1 year old - 80 (21.2%), the second group - from 1 year to 3 years inclusive - 97 (25.7%), the third group - from 4 to 6 years inclusive - 96 (25.5%), the fourth group (control) - from 7 years and older - 104 (27.6%). All patients underwent endoscopic examination of the nasal cavity using rigid endoscopes with a viewing angle of 0 and 30 degrees, 2.7 mm in diameter, and a fibroscope with an inspection angle of 0 degrees, 2.5 mm in diameter.
Results:
The data on the features of the development of the lower nasal passage in children were obtained. Changes in such anatomical parameters as the diameter of the lower nasal passage, the location of the distal opening of the nasolacrimal canal and the lower turbinate itself in the nasal cavity are presented. Highlighted the peak age periods of the development of the lower nasal passage in children: the first 6 months, 3-4 years and 7-8 years of a child's life. It was revealed that in children under 6 months of age, the middle turbinates are closely adjacent to the lower ones, which, as a rule, are large, tightly pressed to the bottom of the nasal cavity, and therefore the lower nasal passages are extremely weakly expressed. With growing up, their diameter grows from less than 2.0 mm to an average value of 2.90±0.03 mm, while after 7 years, fully formed volumetric lower nasal passages are already noted. In newborns and children of the first year of life, the mouth of the nasolacrimal duct is as close as possible to the bottom of the nasal cavity, and during growing up it gradually shifts upward (finally settling in the area of the fornix of the lower nasal passage or in the area of transition of the fornix to the lateral wall of the lower nasal passage) and posterior to the anterior the end of the inferior turbinate (up to 4 years old is at a distance of less than 1.0 cm, from 4 to 6 years old - 1.0 cm, from 7 years old - 1.14±0.01 cm).
Conclusions:
The data obtained as a result of the study are necessary for an otorhinolaryngologist and an ophthalmologist for a full understanding of the processes of development and course, as well as methods of treating various combined rhinological and dacryological pathologies in children.
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