OBJECTIVE: To evaluate the efficacy and onset time of single dermatophagoides farina sublingual immunotherapy in patients sensitized to dermatophagoides farina (Df) and dermatophagoides pteronyssinus (Dp), discuss the mechanism of single allergen immunotherapy in polysensitized patients and provide evidence for clinical applications. METHOD: This is a retrospective study, we screen 50 patients with allergic rhinitis sensitized to Df and Dp in our department. The average age of those patients is 28.98 +/- 2.41 years old. The nasal symptom scores of sneezing, itching, obstruction and runny nose are recorded after three to six months. SPSS 20.0 software is used to analyze the data. RESULT: After treatment for 3 months with sublingual immunotherapy, the TNSS (P < 0.05), score of sneezing (P < 0.01) and runny nose (P < 0.01) is significantly decreased comparing with that before treatment. The scores of obstruction and itching are increased, but the differences are not statistically significant. After treatment for 6 months, the TNSS (P < 0.01), score of sneezing (P < 0.01), itching (P < 0.01), obstruction (P < 0.05) and runny nose (P < 0.01) are all decreased, the difference between the scores of 6 month after treatment and that before treatment is statistically significant. And all of the scores (Z = -5.749, P < 0.01, sneezing; Z = -5.353, P < 0.01, runny nose; Z = -3.476, P < 0.01, congestion; Z = -3.824, P < 0.01, itching; Z = -5.746, P < 0.01, TNSS) at 3 month after treatment are significant higher than that after 6 month treatment. CONCLUSION The onset time of single Df sublingual immunotherapy for patients sensitized to Dp and Df with allergic rhinitis is 12 weeks, and the efficacy is enhanced as time of the treatment.
Adolescent ; Adult ; Aged ; Animals ; Antigens, Dermatophagoides ; administration & dosage ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Rhinitis, Allergic ; therapy ; Sublingual Immunotherapy ; Treatment Outcome ; Young Adult

OBJECTIVE: To clarify the correct diagnostic methods of FBPS of children, and to explore techniques and technology of surgical operation aim to complete excision of sinus tract and preservation of the recurrent laryngeal nerve through analyzing the clinical characteristics and the characteristics of open neck surgery in FBPS of children. METHOD: Clinical materials of 6 children FBPS with internal pyriform sinus were retrospectively analyzed, and literatures were studied to explore the appropriate surgical management of children FBPS; lesions of 6 patients were completely dissected by open neck surgery with the help of di-direction catheterization revealing the tract of fistula, and the openings of the fistula to pyriform apex were cauterized by monopolar coagulation at the end of the procedure; all 6 cases were with systematic endoscopic follow-up. RESULT: All cases of 6 children patients were cured by open neck surgery, no recurrence of clinical symptoms were observed during a mean follow-up of 14 months (1-3 years); 2 cases were diagnosed with an "anatomical" relapse (persistence of the sinus tract orifice without clinical symptoms) at the follow-up endoscopy(at 3 and 4 months after surgery); all 6 cases had no complication of laryngeal paralysis. CONCLUSION The children patients presenting recurrent acute suppurative thyroiditis and deep neck abscess of anterior area in the lower part of neck, especially locating left neck, should be considered as the diagnosis of FBPS. also the same as confirmed by enhanced neck CT scan and direct laryngoscopy. Patients with identification of internal pyriform sinus and Betz fold by direct laryngoscopy, and with identification of fistula which passes through the cricothyroid membrane beneath the superior laryngeal nerve can be confirmed FBPS. Completely dissection of sinus tract by open neck surgery was the effective management of children FBPS and di direction catheterization aids to reveal and identify the tract of fistula. Resection of the posterior part of the thyroid cartilage ala can be useful to aid exposure and preservation of the recurrent laryngeal nerve; but co-excision of a portion of the upper of the thyroid gland aids to the entire dissection of lesions. In addition, cauterizing the opening of the fistula to pyriform apex may be useful to obliterate the internal opening of pyriform sinus.
Adolescent ; Branchial Region ; abnormalities ; Child ; Child, Preschool ; Female ; Fistula ; diagnosis ; surgery ; Humans ; Male ; Neck ; Retrospective Studies