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目的探讨成年嗜酸粒细胞性慢性鼻-鼻窦炎伴鼻息肉(eosinophilic chronic rhinosinusitis with nasal polyps,e CRSw NP)伴腺样体肥大(adenoid hypertrophy,A H)的临床特点,并对A H与慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)的相关性进行分析。方法经临床、电子鼻咽镜和影像检查发现1例慢性鼻-鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSw NP)伴鼻咽部肿块患者,完善相关检查,行全麻双侧功能性内镜鼻窦手术(FESS)+鼻内镜下鼻咽肿块切除术,双侧鼻腔息肉和鼻咽肿块分别送病理。结果术后第2天抽取鼻腔填塞物,未发生任何并发症,病理:送检“双侧鼻腔息肉”符合息肉,且镜下大量嗜酸性粒细胞浸润;送检“左、右鼻咽肿块”黏膜慢性炎伴淋巴组织增生,符合腺样体组织。术后1个月随访,鼻内镜下观察双侧鼻腔无明显息肉,各窦口开放,引流通畅,腺样体无明显残留。患者主诉术后无明显鼻塞,无张口呼吸,耳鸣、耳闷较术前明显好转,无其他明显不适。结论 AH与CRS具有相关性,前者可能是后者发病的重要原因之一,而后者亦可能是促进前者发病的因素之一,两者的综合和协同治疗对改善患者症状具有至关重要作用。
Objective To investigate the clinical features of eosinophilic chronic rhinosinusitis with nasal polyps (e CRSw NP) and adenoid hypertrophy (AH) Sinusitis (chronic rhinosinusitis, CRS) were analyzed. Methods One case of chronic rhinosinusitis with nasal polyps (CRSw NP) with nasopharyngeal mass was diagnosed by clinical, electronic nasopharyngoscopy and imaging examination. The related tests were completed and the bilateral functional general anesthesia Endoscopic sinus surgery (FESS) nasal endoscopic nasopharyngeal ablation, bilateral nasal polyps and nasopharyngeal mass were sent to the pathology. Results Nasal packing was taken on the second postoperative day without any complications. The pathology was examined with “bilateral nasal polyps” in line with polyps and a large number of eosinophils were infiltrated under the microscope. Pharyngeal mass "mucosal chronic inflammation with lymphoid hyperplasia, in line with adenoid tissue. After one month follow-up, there was no obvious polyp in bilateral nasal cavity under nasal endoscopy. The sinus ostium was open and the drainage was smooth and there was no obvious residual adenoid. Patients complained of no significant postoperative nasal obstruction, no mouth breathing, tinnitus, ear boring significantly improved compared with preoperative, no other obvious discomfort. Conclusions There is a correlation between AH and CRS. The former may be one of the important causes of the latter. The latter may be one of the factors to promote the pathogenesis of the former. The combination of the two can play an important role in improving the symptoms of the patients.