Dokument

Zusammenfassung:
Die chronische Rhinosinusitis ist eine häufige Erkrankung, die mit hohen Kosten für das Gesundheitswesen einhergeht. In vereinzelten Fällen kommt es durch postnasalen Abfluss entzündlichen Sekrets zum sogenannten Post-Nasal-Drip Syndrom, das mit nächtlicher Bronchokonstriktion und Reizhusten einhergehen kann. Die PNDS-assoziierten nächtlich auftretenden akustischen Phänomene wie Schnarchen, Schlucken, Husten und Wheezing wurden bislang nicht simultan in diesem schwer erfassbaren Zeitraum registriert und analysiert. Mit dem Lung Sound Monitor wurden zur Untersuchung dieses Sachverhalts bei 20 Patienten mit chronischer Rhinosinusitis und 20 gesunden Probanden eine ambulante Messung nächtlicher Atemgeräusche durchgeführt. Es wurde dann ein Vergleich nächtlicher akustischer Symptome mittels Student’s T-Test und Mann-Whitney-U-Test durchgeführt. Bei 25% der Patienten mit Rhinosinusitis wurde ein manifestes PNDS mit nächtlichen obstruktiven Atemgeräuschen diagnostiziert. Patienten mit chronischer Rhinosinusitis schlucken im Durchschnitt mit 8,58 ± 4,2 Ereignissen/h dreimal häufiger als das gesunde Vergleichskollektiv (5,48 ± 3,15 Ereignissen/h). Dieser Unterschied war signifikant (p=0,01). Nächtliches Wheezing wurde bei sechs Patienten registriert. Im Median unterschied sich die Wheezingrate (Anteil von Wheezing an der Messzeit) nicht zwischen Patientenund Probandenkollektiv. Statistisch war eine Tendenz erkennbar (p=0,108). Schnarchen und Husten trat tendenziell häufiger bei den Patienten auf. Diese Unterschiede waren statistisch nicht signifikant. Anhand der Ergebnisse der Studie lässt sich folgern, dass bei Patienten mit Rhinosinusitis Veränderungen der pharyngealen Drainage von Sekret mit obstruktiven Atemgeräuschen assoziiert sind. Zur Untermauerung dieser Hypothese sind Studien mit größeren Stichproben nötig. Ebenso erscheint es sinnvoll, zeitliche Zusammenhänge zwischen nächtlichen Symptomen zu untersuchen.

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