Nasal obstructive disorders induce medical treatment failure in paediatric persistent allergic rhinitis (The NODPAR Study)
| Autor: | Franklin Mariño-Sánchez, Isam Alobid, Joaquim Mullol, Karen Ruiz-Echevarría, Ana María Plaza-Martin, Oliver Haag, Meritxell Valls-Mateus, María T. Giner-Muñoz, Rosa Jiménez-Feijoo, Jaime Lozano-Blasco, Paulina Cardenas-Escalante, Jesús Rodríguez-Jorge |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Allergy Adolescent Immunology Drug Resistance Histamine Antagonists Disease Nod Turbinates Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Recurrence Internal medicine Prevalence Deformity Humans Immunology and Allergy Medicine Prospective Studies Treatment Failure Child 030223 otorhinolaryngology Administration Intranasal Nasal Septum Medical treatment business.industry Plastic Surgery Procedures Hyperplasia medicine.disease Rhinitis Allergic Surgery 030228 respiratory system Spain Chronic Disease Pediatrics Perinatology and Child Health Leukotriene Antagonists Female Steroids Nasal administration Nasal Obstruction medicine.symptom business Nasal symptoms |
| Zdroj: | Pediatric Allergy and Immunology. 28:176-184 |
| ISSN: | 0905-6157 |
| Popis: | Background Allergic rhinitis (AR) is the most common chronic disease among children. To characterize the disease, a modified classification of severity (m-ARIA) has recently been validated in AR children. When medical treatment fails, surgery for nasal obstructive disorders (NOD) may be a therapeutic option. Our objective was to assess the prevalence of NOD and their influence in medical treatment response among children with persistent AR (PER). Methods In a prospective, real-life study, 130 pediatric PER patients (13.1±2.8 years, females 31.5%, severe rhinitis 49%) referred from Allergy to ENT department were assessed for their response (R, responders; NR, non-responders) to medical treatment (intranasal steroids and antihistamines or antileucotriens) by direct questioning and nasal symptoms VAS, the presence of NOD (septal deformity, turbinate enlargement and adenoidal hyperplasia), comorbidities, nasal symptoms, rhinitis severity (modified-ARIA criterion) and asthma control (International Consensus On Pediatric Asthma criterion). Results After two months of treatment, the NR group presented a higher prevalence of obstructive septal deformity and severe inferior turbinate enlargement when compared with the R group. Higher septal deformity and turbinate enlargement scores were strongly associated with treatment refractoriness. The prevalence of severe PER was also higher for the NR group. Higher asthma control scores were associated with the probability of treatment-induced improvement. Conclusions In pediatric PER patients, medical therapy refractoriness was associated with NOD, mainly septal deformity and turbinate enlargement. In those patients, ENT examination will facilitate an early NOD diagnosis in order to indicate potential corrective surgery. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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