小児鼻副鼻腔炎病態の現状

学童検診結果より

抄録

From May to June, 1980, 2, 238 school children from 7 primary schools in Miyagi prefecture were oto-rhinologically examined to estimate an accurate incidence of chronic rhino-sinusitis in school children. Five of the 7 schools are located in the rural area and the remaining 2 schools are located in the urban area.
The following results were obtained;
1) Nasal secretion was diagnosed to be abnormal in 56.5% of the children, including serous in 17.6%, mucous in 25.5% and purulent in 13.4%.
2) The nasal smear test showed massive infiltration of neutrophils in 22.9%, eosinophils in 5.8% and both cells in 3.8%.
3) X-ray examination of the paranasal sinuses was performed in 347 children from 4 primary schools (Two in the rural and the other two in the urban areas). Abnormal findings indicating paranasal sinusitis were detected in 179 cases. Thus chronic sinusitis is found in 10.5% of the children in the 4 schools.
4) Statistical analyses showed that there was the significant difference of incidences of the chronic snusitis in the children between the rural (15.1%) and urban (7.9%) areas (p<0.01).
5) The X-ray examination showed the first grade children were affected by the chronic sinusitis most frequently. The incidence gradually decreased as the grade progressed.
6) The massive infiltration of neutrophils in the nasal smear was most frequently observed in the first grade and its incidence also decreased as the grade progressed. The infiltration of eosinophils, on the contrary, persisted throughout the all grades of the primary school children.
7) The maturation of imniunological mechanisms of the upper respiratory tract seems to play a role in this spontaneous subsidance of the recurrent rhino-sinusitis in the primary school children, although no marked declining of the incidence was seen in the cases of the immediate-type allergic reaction.