Screening sinus CT scans in pediatric bone marrow transplant patients

被引:25
作者
Billings, KR [1 ]
Lowe, LH
Aquino, VM
Biavati, MJ
机构
[1] Childrens Med Ctr, Div Pediat Otolaryngol, Dallas, TX 75235 USA
[2] Childrens Med Ctr, Dept Radiol, Dallas, TX 75235 USA
[3] Childrens Med Ctr, Dept Pediat Hematol Oncol, Dallas, TX 75235 USA
[4] Univ Texas, SW Med Ctr, Dept Otorhinolaryngol, Dallas, TX 75235 USA
[5] Univ Texas, SW Med Ctr, Dept Pediat, Dallas, TX USA
关键词
sinusitis; bone marrow transplantation;
D O I
10.1016/S0165-5876(00)00296-2
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objective: To determine how sinus disease noted on pre-bone marrow transplant (BMT) screening sinus computed tomography (CT) scans relates to subsequent development of clinical and/or radiographic sinusitis and correlates with overall prognosis. Methods: A retrospective review of medical records, CT scans, and BMT database statistics was performed on all pediatric BMT recipients from January 1992 through December 1997. Fifty-four pre-BMT CT scans were performed on 51 children, aged from 2 months to 17 years. Sinus disease was staged according to criteria established by Lund and Kennedy [V.J. Lund, D.W. Kennedy, Ann. Otol. Rhinol. Laryngol. S167 (1995) 17-21.]. Results: The average age of BMT recipients was 6.8 years. Most common oncologic diagnoses included acute myelogenous leukemia (37%), acute lymphoblastic leukemia (17%), and stage IV neuroblastoma (13%). Screening sinus CT scans were routinely performed 1-3 months prior to BMT. On pre-BMT CT scans 48% of the patients had no evidence of sinus disease, 25.9% mild disease, 9.3% moderate disease, and 16.7% severe disease. Two-thirds (66.7%) of patients with severe sinus disease on pre-BMT CT scans experienced clinical sinusitis post-BMT. In contrast, sinus symptoms were much less common (21.4%) in those with mild disease on CT scan. Overall, 39.3% of patients with sinus abnormalities on pre-BMT CT scans had clinical sinusitis during their post-BMT course, compared to 23.1% of those with normal CT scans pre-BMT. In addition, those patients demonstrating sinus disease on their pre-BMT CT scan were more likely to have radiographic sinusitis post-BMT (25.0%) than those with no disease (7.7%). Seventy-eight percent of those with severe sinusitis had died by 2-year follow up, compared to 69.2% of patients with normal CT scans pre-BMT. Conclusions: Severity of radiographic sinus disease on pre-BMT CT scans was noted to correlate with clinical and radiographic sinusitis later in the post-BMT course, and was associated with a trend toward decreased survival. Pre-BMT CT scans may be useful in determining which children need early and more aggressive intervention for clinical sinusitis post-BMT. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.
引用
收藏
页码:253 / 260
页数:8
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