Video Endoscopic Method of Estimation State of Nasal and Pharyngonasal Cavity in Children with Bronchial Asthma
The aim of the investigation is to study the information value of video endoscopy method to estimate the state of nasal and pharyngonasal cavity in children with bronchial asthma.
Materials and Methods. There were examined 70 children with atopic bronchial asthma, mean age being 10.5±4.2 years. In addition to general clinical, allergic, and functional examination, all the patients were performed video endoscopic examination of nasal and pharyngonasal cavity using endoscopic equipment — rigid rhinoscopes (Karl Storz, Germany), with vision angle 0 and 30°, and diameter 2.7 and 4.0 mm.
Results. The use of video endoscopy in all children with asthma enabled to reveal the symptoms of allergic rhinitis in the remission or exacerbation stage, other pathologies of nasal and pharyngonasal cavity, including nonspecific infectious rhinitis, acute bacterial rhinosinusitism, anomalies of intranasal structures, pharyngeal tonsil hypertrophy being found in 89% (62/70).
Intraarticular structures anomalies were found in 63% (44/70) children with asthma. Against the background of these anomalies, rhinitis was of persisting character, children with the state of moderate severity (32 children) and severe course of the disease (12 children) prevailing. 14 patients anomalies were combined with hyperplastic changes of nasal mucosa.
Pharyngeal tonsil hypertrophy was found in 54% (38/70) of patients with asthma, frequently combined with the signs of venous stasis in the mucosa of inferior nasal conchas. 14 patients had combined hypertrophy of pharyngeal and palatine tonsils. On the whole, pathology of lymphoepithelial pharyngeal circle including chronic tonsillites and pharyngites was diagnosed in 69% (48/70) of children.
Conclusion. The results of video endoscopy application in children with bronchial asthma demonstrate high comorbidity of allergic rhinitis with other nasal and nasopharyngeal pathologies in childhood. A high information value of the technique enables to present the details of nasal obstruction causes in asthmatic patients offering the opportunities of individual therapy in this group of patients in order to receive maximum clinical effect and level down the negative effect of upper respiratory pathologies on bronchial asthma course.
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