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Sinusitis and bronchial asthma in children
1Department of Pediatrics, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Insights
Sinusitis in children with asthma is common, affecting over half of patients. Treating sinusitis may reduce the severity of asthma symptoms and medication needs.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Otolaryngology
Background:
- Sinus disease is often presumed in pediatric patients with respiratory allergies.
- Asthma and sinusitis frequently coexist in children, impacting respiratory health.
Purpose of the Study:
- To investigate the prevalence and characteristics of sinus disease in children with asthma.
- To explore the relationship between sinusitis and asthma severity, and the impact of treatment.
Main Methods:
- Evaluated 375 children (5-15 years) with childhood-onset asthma using Waters radiographs.
- Assessed immunoglobulin E (IgE) levels and other inflammatory markers.
- Treated patients with antibiotics, with a subset requiring surgical intervention.
Main Results:
- Sinus disease was detected in 54.7% of asthmatic children via radiographs.
- Mucosal thickening was the most common finding (67.3%), followed by opacification and air-fluid levels.
- Higher IgE levels were observed in non-sinusitis asthmatic children compared to those with sinusitis.
Conclusions:
- Sinusitis may exacerbate chronic reactive lower airway disease in children.
- Effective sinusitis treatment could potentially reduce the reliance on asthma medications.
Abstract:
Sinus disease has been assumed to exist in children with respiratory tract allergies. We consecutively evaluated 375 patients (245 male, 130 female) with childhood onset asthma, between 5 and 15 years of age (mean 7.8 years of age). Abnormal Waters radiographs were found in 205 patients (54.7%) which included mucosal wall thickening greater than 6 mm (67.3%), complete opacification (22.9%) and air-fluid levels (9.8%). The level of immunoglobulin (Ig) E was found to be much higher in non-sinusitis asthmatic children than in asthmatic children with sinusitis (1207 IU/mL vs. 644 IU/mL). The IgG, IgA, IgM and erythrocyte sedimentation rate (ESR) values were not significantly different in the two groups. All patients were treated with antibiotics for 3 to 6 weeks. Five patients required surgical intervention after antibiotic treatment had little success. Streptococcus viridans was isolated from 4 patients following surgical aspirates and Peptostreptococcus anaerobius was isolated in only one patient. In conclusion, sinusitis in children may be an aggravating factor for chronic reactive lower airway disease. Optimal treatment may decrease the need of asthmatic medication.