Nasal symptoms and signs in children suffering from asthma.

OBJECTIVE: A link between the upper and lower airways has been convincingly demonstrated both in health and disease. To what extent the nose may be involved in children's asthma, has so far not been thoroughly investigated. In this study, we compared symptoms and signs from the upper airways in children with asthma and in children without to find out more about this. METHODS: The study group included 27 asthmatic children, the control group 29 age and sex-matched healthy volunteers. The children were investigated by a senior ENT-specialist. Their parents completed questionnaires about symptoms and signs of upper airway disorders. Skin prick tests, total IgE, acoustic rhinometry, and an X-ray of the epipharynx were performed. The data from the groups were compared. RESULTS: Nasal blockage, mouth breathing, day time sleepiness, apnoeas, itching, sneezing, and hearing impairment were more prevalent in asthmatics compared with controls (p<0.05). For nasal blockage the mean VAS-scores were 52.4 and 30.6 for asthmatics and controls, respectively. For daytime sleepiness the corresponding figures were 34.6 and 23.1. The adenoid-nasopharynx-index was larger, indicating reduced palatal airway in the former compared with the latter (p<0.05). CONCLUSIONS: As the site of upper airway obstruction in asthmatic children appears to be the epipharynx, the adenoids may play a key-role.

CT of the oral vestibule with distended cheeks.

PURPOSE: To evaluate patient compliance in CT examination of the oral vestibule with distended, blown-up cheeks and to determine how often such images provided additional information when disease processes in this area were suspected. MATERIAL AND METHODS: Fifty-four patients were examined with CT of the oral vestibule with distended cheeks and 16 of them had diseases where oral vestibule affection was considered possible. RESULTS: Fifty-three of 54 patients were able to perform cheek distension. Of 16 patients with possible disease involvement of the oral vestibule, additional information was thus obtained in 11 patients. CONCLUSION: When lesions involving the oral vestibule or adjacent regions are suspected, CT examination with distended cheeks is recommended as a routine procedure. The oral vestibule separates the teeth and gingiva from the buccal mucosa of the lips and cheek. On CT images of the oral region, the buccal and gingival mucosa are not separated and thus difficult to define. Problems may arise in deciding whether or not a limited tumorous or infectious lesion of the gingiva also involves the buccal region and vice-versa. We observed that images with distended, blown-up cheeks could be useful in this respect, as the air separated the gingival from the buccomasseteric region and allowed a determination of buccal distensibility. The purpose of the present report was to establish how well the patients could co-operate in performing the CT examination with distended cheeks, and how often such images provided additional information in patients with disease processes which might affect the oral vestibule.