코곁굴염이 동반된 특발안와염의 임상양상
Clinical Characteristics of Idiopathic Orbital Inflammation Accompanied with Paranasal Sinusitis
4
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 특발안와염(idiopathic orbital inflammation, IOI)에서 코곁굴염이 동반된 경우의 임상양상을 밝힌다. 대상과 방법: 2009년 1월부터 2016년 12월까지 IOI로 진단받은 환자들의 기록을 후향적으로 비교하여 분석하였다. 이 연구는 영상검사를 비롯한 의무기록이 존재하며, 12개월 이상 경과 관찰한 환자를 대상으로 하였다. 환자들은 코곁굴염의 유무에 따라 두 그룹으로 나뉘어 분석되었다. 결과: 101명의 IOI 환자 중 13명(12.9%)에서 코곁굴염이 확인되었다. 증상 중 통증을 호소하는 환자가 코곁굴염이 동반된 경우(69.2%) 그렇지 않은 환자에서보다 더 많았다(25.0%, p=0.003). 재발은 코곁굴염이 동반된 경우 69.2%, 코곁굴염이 동반되지 않은 경우 34.1%로, 코곁굴염이 동반된 경우에 더 많았다(p=0.033). 추가적인 면역억제제나 방사선 치료가 필요했던 경우도 코곁굴염이 동반되지 않은 환자에서 9.1%, 동반된 환자에서 38.5%로, 코곁굴염이 동반된 경우 더 많았다(p=0.039). 결론: IOI 환자에서 코곁굴염이 동반된 경우 스테로이드 치료 후 재발하는 빈도가 더 높았다. IOI에서 코곁굴염이 동반된 경우에는 더욱 세심한 치료가 필요하며, 코곁굴염에 대한 적절한 치료가 도움이 될 수 있다.
Abstract
Purpose: To investigate the clinical characteristics of idiopathic orbital inflammatory disease (IOI) with paranasal sinusitis. Methods: This study is a retrospective, comparative case series of patients who were diagnosed with IOI between January 2009 and December 2016. This study included patients with available medical and radiologic data at diagnosis and who participated in follow-up for more than 12 months after treatment. The patients were divided into two groups according to accompaniment of paranasal sinusitis and were compared. Results: Among 101 patients with IOI, 13 (12.9%) were identified to have paranasal sinusitis. The incidence of pain was higher in patients with sinusitis (69.2%) than in patients without sinusitis (25.0%, p = 0.003). More patients with paranasal sinusitis experienced recurrence after systemic steroid therapy (69.2%) than in the other group (34.1%, p = 0.033). Additional immunosuppressants and/or radiation therapy were needed only in 9.1% patients without sinusitis but in 38.5% patients with sinusitis (p = 0.039). Conclusions: IOI patients with sinusitis showed a significantly higher recurrence rate. More careful follow-up of patients during steroid tapering and treatment of sinusitis might be helpful to prevent recurrence of IOI.
참고문헌 (22)
- Yuen SJ, "Idiopathic orbital inflammation: distribution, clinical features, and treatment outcome", Arch ophthalmol, 121, pp.491~499 (2003)
- Mombaerts I, "What is orbital pseudotumor?", Surv Ophthalmol, 41, pp.66~78 (1996)
- Rubin PA, "Etiology and management of idiopathic orbital inflammation", Am J Ophthalmol, 138, pp.1041~1043 (2004)
- Takano K, "A study of infraorbital nerve swelling associated with immunoglobulin G4 Mikulicz's disease", Mod Rheumatol, 24, pp.798~801 (2014)
- Hardy TG, "Enlargement of the infraorbital nerve: an important sign associated with orbital reactive lymphoid hyperplasia or immunoglobulin g4-related disease", Ophthalmology, 121, pp.1297~1303 (2014)
- Lee KH, "Implications of enlarged infraorbital nerve in idiopathic orbital inflammatory disease", Br J Ophthalmol, 100, pp.1295~1300 (2016)
- Leibovitch I, "Paranasal sinus inflammation and non-specific orbital inflammatory syndrome: an uncommon association", Graefes Arch Clin Exp Ophthalmol, 244, pp.1391~1397 (2006)
- Eshaghian J, "Sinus involvement in inflammatory orbital pseudotumor", Arch Ophthalmol, 99, pp.627~630 (1981)
- Yan J, "36 case idiopathic orbital inflammatory pseudotumor with sinus involvement", Lin Chuang Er Bi Yan Hou Ke Za Zhi, 16, pp.410~411 (2002)
- Li J, "Relationship between dacryoadenitis subtype of idiopathic orbital inflammatory pseudotumor and paranasal sinusitis", Int J Ophthalmol, 9, pp.444~447 (2016)
- Deshpande V, "Consensus statement on the pathology of IgG4-related disease", Mod Pathol, 25, pp.1181~1192 (2012)
- 성미선, "안와가성종양의 임상양상과 스테로이드 반응성에 대한 분석", 대한안과학회지, 54(2), pp.185~191 (2013), 대한안과학회
- 박성준, "안와가성종양의 임상분류와 치료", 대한안과학회지, 49(9), pp.1379~1386 (2008), 대한안과학회
- DeConde AS, "Chronic rhinosinusitis: Epidemiology and burden of disease", Am J Rhinol Allergy, 30, pp.134~139 (2016)
- Piao Y, "Concomitant occurrence of Mikulicz's disease and immunoglobulin G4-related chronic rhinosinusitis: a clinicopathological study of 12 cases", Histopathology, 68, pp.502~512 (2016)
- McNicholas MM, "Idiopathic inflammatory pseudotumour of the orbit: CT features correlated with clinical outcome", Clin Radiol, 44, pp.3~7 (1991)
- Smith TL, "Medical therapy vs surgery for chronic rhinosinusitis: a prospective, multi-institutional study with 1-year follow-up", Int Forum Allergy Rhinol, 3, pp.4~9 (2013)
- Bassiouni A, "When FESS fails: the inflammatory load hypothesis in refractory chronic rhinosinusitis", Laryngoscope, 122, pp.460~466 (2012)
- Bassiouni A, "Does mucosal remodeling in chronic rhinosinusitis result in irreversible mucosal disease?", Laryngoscope, 122, pp.225~229 (2012)
- Mombaerts I, "Surgical debulking for idiopathic dacryoadenitis: a diagnosis and a cure", Ophthalmology, 121, pp.603~609 (2014)
- Menger MD, "Surgical trauma: hyperinflammation versus immunosuppression?", Langenbecks Arch Surg, 389, pp.475~484 (2004)
- Dagi Glass LR, "Orbital inflammation: Corticosteroids first", Surv Ophthalmol, 61, pp.670~673 (2016)