소아의 만성비부비동염에 동반되는 비용의 임상양상 및 조직학적 특성 : 성인과의 비교연구

Abstract

Background and Objectives：Nasal polyps (NPs) in children often make the treatment of chronic rhinosinusitis (CRS) difficult. However, there have been few studies focused on pediatric NPs. The authors attempted to investigate the clinical and pathological features of NP in pediatric CRS by comparing them with those in adult CRS and to determine risk factors for their recurrence. Materials and Methods：This study included a total of 286 adults and 56 children who were diagnosed with CRS with bilateral NPs and were treated at Seoul National University Hospital between 2005 and 2008. Their demographic data and information about comorbidities (allergic rhinitis and asthma), preoperative serum total IgE levels, peripheral blood eosinophil counts and the recurrence of NPs were collected by a retrospective chart review. In addition, the polyp tissues were harvested and stained with hematoxylin-eosin for counting the total number of inflammatory cells, including eosinophils. Results：The prevalence of allergic rhinitis was higher in the pediatric group than in the adult group (46.4% versus 30.8%). However, total IgE levels and the proportion of eosinophilic polyps were lower in the pediatric group than in the adult group (99.2 versus 246.9 kU/L and 16.7% versus 30.1%, respectively). In the pediatric group, patients with asthma, peripheral blood eosinophilia or eosinophilic NPs were at higher risk of NP recurrence. Conclusions：The clinical and pathological characteristics of pediatric patients with NPs were different from those of adult patients. Pediatric patients with asthma, peripheral blood eosinophilia or eosinophilic NPs should be aggressively managed to decrease the recurrence of NPs.