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Page 1: 32 32 図1 プローベの当て方 眼窩下の頬部に水平にプローべをあて,上下左右に約 2cmの範囲で動かし,上顎洞を描出した. 図2 正常エコー

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Page 2: 32 32 図1 プローベの当て方 眼窩下の頬部に水平にプローべをあて,上下左右に約 2cmの範囲で動かし,上顎洞を描出した. 図2 正常エコー

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図1 プローベの当て方眼窩下の頬部に水平にプローべをあて,上下左右に約2cmの範囲で動かし,上顎洞を描出した.

図2 正常エコー両側ともに空気によって描出されず,正常である.

図3 右副鼻腔炎 左正常右は貯留液によって上顎洞が描出されるため副鼻腔炎と診断.左は描出されず正常である.

図4 両側副鼻腔炎両側共に貯留液によって上顎洞が描出され,副鼻腔炎と診断した.

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1�.vqr,stÍu#���v����UV��8�w��#��� 2004Î108Ï956�964.

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3�xÐÑÒ,Ó�Ôy,z�{Õ,|#}��¾��������k��Ö~#����× 2005Î58Ï1011�1014.

4�Ø�qÙ,����,�ÚÛÜ#���_`�¾�� BÝ5Þ�ß�UV>#��¶�:-��� 1989Î92Ï1345�1353.

5�Savolainen S, Pietola M, Kiukaanniemi H, et al.An ultrasound device in the diagnosis of acutemaxillary sinusitis. Acta Otolaryngol Suppl1997Î529Ï148�152.

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8+ ����,��� !�"-�./��+ ����,��� !�"�0�1+23456�2002�7��89: 47�#$%!�;<�=">*2003.

9Landau L. Acute and chronic cough. PaediatrRespir Rev 2006?7%S64�S67.

10Hay AD, Wilson A, Fahey T, et al. The durationof acute cough in pre-school children presentingto primary care%a prospective cohort study.Fam Pract 2003?20%696�705.

11Chang AB, Glomb WB. Guidelines for evaluatingchronic cough in pediatrics%ACCP evidence-based clinical practice guidelines. Chest 2006?129%260S�283S.

12Kemp A. Does post-nasal drip cause cough inchildhood? Paediatr Respir Rev 2006?7%31�35.

13@�AB*CD E*FGHI*J���KLM1NOPQR�STUV���W 1987?91%3788�3794.

14Wald ER, Reilly JS, Casselbrant M, et al. Treat-ment of acute maxillary sinusitis in childhood%acomparative study of amoxicillin and cefaclor. JPediatr 1984?104%297�302.

15Puhakka T, Makela MJ, Alanen A, et al. Sinusitis

in the common cold. J Allergy Clin Immunol1998?102%403�408.

16Kristo A, Uhari M, Luotonen J, et al. Paranasal si-nus findings in children during respiratory infec-tion evaluated with magnetic resonance imaging.Pediatrics 2003?111%e586�589.

17Subcommittee on Management of Sinusitis andCommittee on Quality Improvement. Clinicalpractice guideline%management of sinusitis. Pe-diatrics 2001?108%798�808.

18O�Brien KL, Dowell SF, Schwartz B, et al. AcuteSinusitis-Principles of Judicious Use of Antimi-crobial Agents. Pediatrics 1998?101%174�177.

19XYZ[�\]��^_`a,Kbcdef6g�hijklmn Streptococcus pneumoniae*Haemophilus influenzaeKop�2002q2003��r1sKtuPhvwxyz{O|}R{~e�1O�����ef6W 2005?79%887�894.

20��_`,�OPQRyz{����Kn�K���"�����������2Phv���gO|}Ryz{���� !�"��n�K����_`��^ 2005?8%57�84.

21�� ���>����P�����T, ¡¢��^£Kn�K¤¥2,����¦^ 2006?38%774�778.

The Frequency of Sinusitis Associated with Prolonged Coughing in Children

Tatsuo NishimuraNishimura Pediatric Clinic

Objective%The frequency of sinusitis associated with prolonged coughing in children was examined andthe underlying disease causing the coughing was considered.

Methods%Children aged 4�9 years old who underwent medical check-up by a practicing pediatric physi-cian at �Nishimura pediatric clinic� between January and December 2005, and demonstrated coughing persist-ing for more than 10 days without pyrexia were enrolled in this study as the coughing group. Children withpyrexia but not coughing were enrolled as the control group in July 2006. Echo check of the maxillary sinuswas performed to examine children in the two groups and subjects were diagnosed as sinusitis positive whenmaxillary sinus demonstrated a liquid pool or as sinusitis negative when the sinus demonstrated air.

Results%The coughing group consisted of 57 children (27 boys and 30 girls), aged 5.81§1.69 years old(mean§SD), duration of coughing was 18.1§8.1days. Sinus echo was positive and 34 cases (59.6¨) were diag-nosed as having sinusitis. The control group was comprised of 38 children (18 boys and 20 girls), aged 5.16§1.95 years old, and sinus echo was positive in only one child in this group. There was a significant difference inthe incidence of sinusitis between the coughing group and the control group (p©0.01).

Among the 34 sinusitis-positive children in the coughing group, there were 17 boys and 17 girls, aged5.44§1.44 years old. Among 23 cases showing negative findings, there were 10 boys and 13 girls, aged 6.35§1.92 years old. Acute otitis media developed in 6 cases (17.6¨) and otitis media with effusion developed 6 cases(17.6¨) during the clinical course in the sinusitis-positive group. One case (4.3¨) of acute otitis media and 2cases of otitis media with effusion developed in the group with negative findings. Allergic airway disease suchas allergic rhinitis or bronchial asthma was found in 9 cases (26.5¨) in the sinusitis positive group and 10 case(43.5¨) in the sinusitis-negative group.

Conclusions%There are many cases of sinusitis among pediatric patients with symptoms of prolongedcoughing and ultrasound examination of the maxillary antrum back wall echo are useful for diagnosis.