Section: 
Science articles
Science articlesComorbid pathology of upper respiratory tract in children with atopic bronchial asthma
S. V. Krasil’nikova (1), T. I. Eliseeva (1), A. V. Shakhov (1), I. I. Balabolkin (2)
(1) Federal State Budgetary Educational Institution of Higher Vocational Education „Privolzhskiy Research Medical University“ of the Ministry of Healthcare of Russia, 603005, Nizhny Novgorod, Russia
(2) Federal State Budgetary Institution Scientific Center for Children’s Health of the Russian Academy of Sciences, Moscow, Russia
UDK: 616.248+616.211/.232-053.2
DOI: https://doi.org/10.18692/1810-4800-2018-4-69-77
ABSTRACT
The objective of the work is to study the upper respiratory tract pathology in children with atopic bronchial asthma (BA).
Patients and methods. The authors have examined 280 children with atopic BA, their average age is 10.5±4.2 years. The control group consists of 108 children with the complaints of nasal breathing obstruction, comparable in terms of age (10.3±5.8) and sex, without BA. Alongside with the standard, general clinic, allergological functional test, all the patients have undergone videoendoscopic examination of nasal cavity and nasopharynx, anterior active rhinomanometry, quantitative assessment of nasal symptoms using SNOT-20, TNSS, BA control level assessment was performed using ACQ-5 test.
Results. The symptoms of allergic rhinitis (AR) of variable severity, with the predominance of persistent forms have been revealed in all children. The authors have established the positive correlational interrelation between asthma control level and the intensity of AR symptoms. The patients with bronchial asthma are characterized with the impaired nasal respiratory function in comparison with the control group. The nasal obstruction is caused by allergic inflammation of the nasal mucosa, as well as by other variants of the nasal cavity and nasopharynx pathology. The pathology of the upper respiratory tract (URT) in 198 (82.5%) children with atopic BA had polymorphic nature. The nasal architectonics defects were detected in 137 (48.9%) children, hypertrophic rhinitis – in 28 (10%) patients, nonspecific infectious rhinitis – in 44 (15.71%) examined persons, pharyngeal tonsil pathology – in 175 (62.5%) patients with bronchial asthma. The authors established the interrelation between the degree of the pharyngeal tonsil hypertrophy and the age of the children – a higher degree of hypertrophy was characteristic for children of younger age group. In the control group, the URT pathology was diagnosed reliably rarer (р < 0.0001).
Conclusion. The results of the examination of children with bronchial asthma prove that these patients generally have AR, inter alia, in combination with other variants of nasal and nasopharynx pathology. Videoendoscopic method makes it possible to itemize the causes of nasal obstruction in the patients with asthma. Verification of causes of nasal obstruction provides individualization of therapy in patients with bronchial asthma and elimination of the negative impact of URT pathology on the progress of asthma.
Publication date:
06.08.2018
Keywords:
bronchial asthma, videorhinoendoscopy, upper respiratory tract pathology, allergic rhinitis, children. For citation:
Krasil’nikova S. V., Eliseeva T. I., Shakhov A. V., Balabolkin I. I. Comorbid pathology of upper respiratory tract in children with atopic bronchial asthma. Rossiiskaya otorinolaringologiya. 2018;4:69–77. https://doi.org/10.18692/1810-4800-2018-4-69-77