Study On Diseases Related To Nasal And Nasopharynx In Children

Objective:To investigate the etiologies and management of security otitis media being silent nature by observing the abnormal configuration without symptoms in preschool children, and Analyse the reason of individual difference.Methods:A retrospective review was performed of81cases(162ears) who had no ear relative symptoms,but had different degree abnormality in drum when they were examined in clinic. All cases underwent routine physical examination,fibric electronic pharyngorhinoscopy, skin prick test, CT examination of sinus, and were estimated whether they were accompany with security otitis media, or not. All cases were divided into3groups by their primary disease, allergic rhinitis, adenoid hypertrophy, and sinusitis. Results:Twenty-nine ears with security otitis media were diagnosed among81cases (162ears)by acoustic admittance. The morbidity rate in3groups was13.6%(6ears) in allergic rhinitis patients,21.2%(11ears) in adenoid hypertrophy patients,18.2%(12ears) in sinusitis patients. The differences among3groups had statistically significant.Conclusions:Allergic rhinitis, adenoid hypertrophy, sinusitis were the potential factors of security otitis media in preschool children, and adenoid hypertrophy had more effect to middle ear. Treat earlier would get more benefit for children. Objective:To analyze the characteristics of sleep structure, heart rate and arousal index (ArI) in primary snoring(PS) children and obstructive sleep apnea hypopnea syndrom (OSAHS) children in mild, moderate or severe by the study on the outcome of113children’s polysomnogram (PSG).Methods:One hundred and thirteen children with sleep disorders were enrolled from January2010to March2012at clinic from the department of ENT, capital institute of pediatrics affiliated children’s hospital, who were examined with PSG. All the data was analyzed statistically by SPSS19.0.Result:(1) There were no statistical difference in age, sleeping time, sleeping efficacy between PS group and OSAHS group, the same in mild, moderate or severe OSAHS (all P>0.05).(2) The proportion of stage I sleeping in four groups was2.6%±1.4%in PS group,32.4%±11.1%in mild OSAHS group,4.7%±1.9%in moderate OSAHS group,8.9%±4.0%in severe OSAHS group (F=6.542, P=0.000). The proportion of stage IV sleeping in four groups was25.3%±5.6%in PS group,5.4%±3.2%in mild OSAHS group,30.6%±9.0%in moderate OSAHS group,21.4%±10.8%in severe OSAHS group (F=7.544, P=0.000). The proportion of stage REM sleeping in four groups was in21.1% ±8.6%PS group,13.9%±4.0%in mild OSAHS group,14.5%±4.9%in moderate OSAHS group,12.3%±6.9%in severe OSAHS group (F=11.204,P=0.000).The proportion of stage Ⅱ and Ⅲ sleeping in four groups had no statistical difference.(3) The average heart rate in stage REM sleeping of four groups was (85±11)、(90±14)、(95±10)、(101±18) beats per minute (F=6.452, P=0.000),and79±10、84±14、86±7、93±16beats per minute in stage NREM sleeping (F=5.369, P=0.002).(4) In four groups, the difference of the total count of spontaneous arousal, the spontaneous arousal count in stage REM and NREM sleeping were all statistically significant (F=56.379,60.781,44.061, all P=0.000).And the difference of the total count of respiratory arousal, the median of respiratory arousal count in stage REM and NREM sleeping were all statistically significant (F=79.250,36.137,65.239, all P=0.000).Conclusions:The heart rate was affected more obviously when children got moderate-severe OSAHS. Comparing with PS children, OSAHS children had a reduction of sponeous arousal and an increasement of respiratory arousal. But the amount of sponeous arousal of OSAHS children didn’t reduce progressively either in stage REM or stage NREM with the progress of OSAHS. Introduction:Upper airway cough syndrome(UACS) is a main reason leading to chronic cough in children.The aim of this study was to investigate the etiology composing of UACS among different age groups in children and to find the impact factor of UACS, So that we could find the clinical diagnostic characters of UACS and the evaluation method of curative effective.Methods and materials:One hundred and three children with chronic cough as chief from ENT clinic of capital institute of pediatrics affiliated children’s hospital between January2013and November2013were included in the study. They were diagnosed with UACS and divided into three groups by age, nurseling child group,preschool child group and school age child group. Visual analogue scale(VAS) was used to evaluated the relief degree of cough before and after the treatment in different age groups. Results:(1)In all103UACS children, there are8cases(7.8%) in nurseling child group,45cases(43.7%) in preschool child group, and50cases(48.5%) in school age child group.(2)Despite the effect of age, the sequencing of etiology composing in103UACS children was rhinitis with adenoid hypertrophy(38cases,36.9%), rhinitis(22cases,21.4%), nasosinusitis(17cases,16.5%), nasosinusitis with adenoid hypertrophy(16cases,15.5%), adenoid hypertrophy(10cases,9.7%). But in different age group, the sequencing of etiology composing was different and had statistical difference, Pearson Chi-square=39.510,P=0.000(<0.05) by SPSS19.0.(3)There were45chilldren with allergic antigen positive in103UACS children,male29cases,female16cases. There was no statistical difference in the allergic antigen positive ratio in different age groups, Pearson Chi-square=1.898, P=0.387(>0.05).(4)There were statistical difference in VAS in different age groups before and after treatment. There were also statistical differences in VAS among every two observing timingt[F=234.556, P=0.000(<0.05)].But there was no statistical difference in diseases that caused UACS[F=0.752, P=0.571(>0.05)].(5) The complications of UACS are buccal respiration6cases (75.0%), snore1case (12.5%), runny nose1case (12.5%) in nurseling child group(8cases), snore23cases (51.1%), buccal respiration13cases (28.9%), nasal obstruction6cases (13.3%), runny nose3cases (6.7%) in preschool child group(45cases) and snore18cases(36.0%), runny nose13cases (26.0%).headache9cases(18.0%), nasal obstruction6cases(12.0%), chest tightness2cases(4.0%), hyposmia1 case(2.0%), buccal respiration1case(2.0%) in school age child group(50cases).Conclusions:(1) School age children had a higher morbidity of UACS than nurseling children and preschool children had.(2) The etiology composing of UACS among different age groups in children was different. Adenoid hypertrophy was the main reason of cough in preschool children with UACS, while in nurseling children and school age children with UACS,that was rhinitis.(3)Although the allergic diseases were the important reason leading to UACS, but they were not the factor that made the different etiology composings of UACS among different age groups in children.(4)The symptom of chronic cough and other complications would evidently improve after the standard treatment despite the age and diagnosis, and the relief had no statistical differences in different age group, but the VAS had statistical differences between before and after treatment.(5)The different complications had a good relevance with the different etiology composings of UACS among different age groups in children.(6)Good communication with parents of UACS children, pay more attention to feeling of theirs, that would be helpful to the diagnosis of UACS.