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Published in: European Archives of Oto-Rhino-Laryngology 3/2011

01-03-2011 | Rhinology

ENT manifestations in patients with primary ciliary dyskinesia: prevalence and significance of otorhinolaryngologic co-morbidities

Authors: J. Ulrich Sommer, Kerstin Schäfer, Heymut Omran, Heike Olbrich, Julia Wallmeier, Andreas Blum, Karl Hörmann, Boris A. Stuck

Published in: European Archives of Oto-Rhino-Laryngology | Issue 3/2011

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Abstract

Primary ciliary dyskinesia (PCD) is a rare inherited disease with a prevalence of about 1:20,000. The underlying pathogenesis is disrupted ciliary function, which results in delayed mucus transportation leading to chronic inflammation, mainly in the upper and lower respiratory tract. Although the pathogenesis of the disease and its clinical presentation is somewhat understood, data regarding the prevalence of accompanying symptoms is limited, especially in the field of otorhinolaryngology. A total of 44 patients diagnosed with PCD answered a questionnaire regarding the diagnosis and clinical presentation of the disease, their medical history and clinical manifestations, and medical treatment in the field of otorhinolaryngology. The majority of participants (70%) had seen a physician more than 50 times before the diagnosis was made at an average age of 10.9 ± 14.4 years. As much as 59% of all patients had recurring problems at the paranasal sinuses and 69% of these patients needed corresponding surgical intervention. Even more patients (81%) suffered from recurring otitis media and, as a result, 78% of these patients underwent paracentesis with temporary tympanostomy tubes at least once at an average age of 9.5 ± 13.0 years. Otorhinolaryngologic symptoms, especially chronic otitis media and chronic rhinosinusitis, are frequently associated with PCD. Surgical intervention to treat these symptoms is common. The awareness of this disease should be raised, especially among ENT physicians, and surgical intervention should be indicated carefully.
Literature
1.
go back to reference Fliegauf M, Benzing T, Omran H (2007) When cilia go bad: cilia defects and ciliopathies. Nat Rev Mol Cell Biol 8(11):880–893CrossRefPubMed Fliegauf M, Benzing T, Omran H (2007) When cilia go bad: cilia defects and ciliopathies. Nat Rev Mol Cell Biol 8(11):880–893CrossRefPubMed
2.
go back to reference Chapman KR, Allen LJ, Romet TT (1990) Pulmonary function in normal subjects following exercise at cold ambient temperatures. Eur J Appl Physiol Occup Physiol 60(3):228–232CrossRefPubMed Chapman KR, Allen LJ, Romet TT (1990) Pulmonary function in normal subjects following exercise at cold ambient temperatures. Eur J Appl Physiol Occup Physiol 60(3):228–232CrossRefPubMed
3.
go back to reference Satir P, Sleigh MA (1990) The physiology of cilia and mucociliary interactions. Annu Rev Physiol 52:137–155CrossRefPubMed Satir P, Sleigh MA (1990) The physiology of cilia and mucociliary interactions. Annu Rev Physiol 52:137–155CrossRefPubMed
4.
go back to reference Nuutinen J, Karja J, Karjalainen P (1983) Measurement of mucociliary function of the eustachian tube. Arch Otolaryngol 109(10):669–672PubMed Nuutinen J, Karja J, Karjalainen P (1983) Measurement of mucociliary function of the eustachian tube. Arch Otolaryngol 109(10):669–672PubMed
5.
go back to reference Hilfinger A, Chattopadhyay AK, Julicher F (2009) Nonlinear dynamics of cilia and flagella. Phys Rev E Stat Nonlin Soft Matter Phys 79(5 Pt 1):051918CrossRefPubMed Hilfinger A, Chattopadhyay AK, Julicher F (2009) Nonlinear dynamics of cilia and flagella. Phys Rev E Stat Nonlin Soft Matter Phys 79(5 Pt 1):051918CrossRefPubMed
6.
go back to reference O’Callaghan C, Chilvers M, Hogg C, Bush A, Lucas J (2007) Diagnosing primary ciliary dyskinesia. Thorax 62(8):656–657CrossRefPubMed O’Callaghan C, Chilvers M, Hogg C, Bush A, Lucas J (2007) Diagnosing primary ciliary dyskinesia. Thorax 62(8):656–657CrossRefPubMed
7.
go back to reference Barbato A, Frischer T, Kuehni CE, Snijders D, Azevedo I, Baktai G, Bartoloni L, Eber E, Escribano A, Haarman E, Hesselmar B, Hogg C, Jorissen M, Lucas J, Nielsen KG, O’Callaghan C, Omran H, Pohunek P, Strippoli MP, Bush A (2009) Primary ciliary dyskinesia: a consensus statement on diagnostic and treatment approaches in children. Eur Respir J 34(6):1264–1276CrossRefPubMed Barbato A, Frischer T, Kuehni CE, Snijders D, Azevedo I, Baktai G, Bartoloni L, Eber E, Escribano A, Haarman E, Hesselmar B, Hogg C, Jorissen M, Lucas J, Nielsen KG, O’Callaghan C, Omran H, Pohunek P, Strippoli MP, Bush A (2009) Primary ciliary dyskinesia: a consensus statement on diagnostic and treatment approaches in children. Eur Respir J 34(6):1264–1276CrossRefPubMed
8.
go back to reference Katsuhara K, Kawamoto S, Wakabayashi T, Belsky JL (1972) Situs inversus totalis and Kartagener’s syndrome in a Japanese population. Chest 61(1):56–61CrossRefPubMed Katsuhara K, Kawamoto S, Wakabayashi T, Belsky JL (1972) Situs inversus totalis and Kartagener’s syndrome in a Japanese population. Chest 61(1):56–61CrossRefPubMed
9.
go back to reference Schrott-Fischer A, Rieger G, Morass B, Bitsche M, Horak E, Riechelmann H, Gluckert R (2008) Diagnostics of primary ciliary dyskinesia. Laryngorhinootologie 87(11):809–820 (quiz 821–825) Schrott-Fischer A, Rieger G, Morass B, Bitsche M, Horak E, Riechelmann H, Gluckert R (2008) Diagnostics of primary ciliary dyskinesia. Laryngorhinootologie 87(11):809–820 (quiz 821–825)
10.
go back to reference Carlen B, Stenram U (2005) Primary ciliary dyskinesia: a review. Ultrastruct Pathol 29(3–4):217–220CrossRefPubMed Carlen B, Stenram U (2005) Primary ciliary dyskinesia: a review. Ultrastruct Pathol 29(3–4):217–220CrossRefPubMed
11.
go back to reference Roomans GM, Ivanovs A, Shebani EB, Johannesson M (2006) Transmission electron microscopy in the diagnosis of primary ciliary dyskinesia. Ups J Med Sci 111(1):155–168CrossRefPubMed Roomans GM, Ivanovs A, Shebani EB, Johannesson M (2006) Transmission electron microscopy in the diagnosis of primary ciliary dyskinesia. Ups J Med Sci 111(1):155–168CrossRefPubMed
12.
go back to reference Fliegauf M, Olbrich H, Horvath J, Wildhaber JH, Zariwala MA, Kennedy M, Knowles MR, Omran H (2005) Mislocalization of DNAH5 and DNAH9 in respiratory cells from patients with primary ciliary dyskinesia. Am J Respir Crit Care Med 171(12):1343–1349CrossRefPubMed Fliegauf M, Olbrich H, Horvath J, Wildhaber JH, Zariwala MA, Kennedy M, Knowles MR, Omran H (2005) Mislocalization of DNAH5 and DNAH9 in respiratory cells from patients with primary ciliary dyskinesia. Am J Respir Crit Care Med 171(12):1343–1349CrossRefPubMed
13.
go back to reference Santamaria F, De Stefano S, Montella S, Barbarano F, Iacotucci P, Ciccarelli R, Sofia M, Maniscalco M (2008) Nasal nitric oxide assessment in primary ciliary dyskinesia using aspiration, exhalation, and humming. Med Sci Monit 14(2):CR80–CR85PubMed Santamaria F, De Stefano S, Montella S, Barbarano F, Iacotucci P, Ciccarelli R, Sofia M, Maniscalco M (2008) Nasal nitric oxide assessment in primary ciliary dyskinesia using aspiration, exhalation, and humming. Med Sci Monit 14(2):CR80–CR85PubMed
14.
go back to reference Zariwala MA, Knowles MR, Omran H (2007) Genetic defects in ciliary structure and function. Annu Rev Physiol 69:423–450CrossRefPubMed Zariwala MA, Knowles MR, Omran H (2007) Genetic defects in ciliary structure and function. Annu Rev Physiol 69:423–450CrossRefPubMed
15.
go back to reference Noone PG, Leigh MW, Sannuti A, Minnix SL, Carson JL, Hazucha M, Zariwala MA, Knowles MR (2004) Primary ciliary dyskinesia: diagnostic and phenotypic features. Am J Respir Crit Care Med 169(4):459–467CrossRefPubMed Noone PG, Leigh MW, Sannuti A, Minnix SL, Carson JL, Hazucha M, Zariwala MA, Knowles MR (2004) Primary ciliary dyskinesia: diagnostic and phenotypic features. Am J Respir Crit Care Med 169(4):459–467CrossRefPubMed
16.
go back to reference Ernstson S, Afzelius BA, Mossberg B (1984) Otologic manifestations of the immotile-cilia syndrome. Acta Otolaryngol 97(1–2):83–92CrossRefPubMed Ernstson S, Afzelius BA, Mossberg B (1984) Otologic manifestations of the immotile-cilia syndrome. Acta Otolaryngol 97(1–2):83–92CrossRefPubMed
17.
go back to reference Coren ME, Meeks M, Morrison I, Buchdahl RM, Bush A (2002) Primary ciliary dyskinesia: age at diagnosis and symptom history. Acta Paediatr 91(6):667–669CrossRefPubMed Coren ME, Meeks M, Morrison I, Buchdahl RM, Bush A (2002) Primary ciliary dyskinesia: age at diagnosis and symptom history. Acta Paediatr 91(6):667–669CrossRefPubMed
18.
go back to reference R-Development-Core-Team (2010) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria R-Development-Core-Team (2010) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria
19.
go back to reference Campbell RG, Birman CS, Morgan L (2009) Management of otitis media with effusion in children with primary ciliary dyskinesia: a literature review. Int J Pediatr Otorhinolaryngol 73(12):1630–1638CrossRefPubMed Campbell RG, Birman CS, Morgan L (2009) Management of otitis media with effusion in children with primary ciliary dyskinesia: a literature review. Int J Pediatr Otorhinolaryngol 73(12):1630–1638CrossRefPubMed
20.
go back to reference Lesic I, Maurer E, Strippoli MP, Kuehni CE, Barbato A, Frischer T (2009) Primary ciliary dyskinesia (Pcd) in Austria. Wien Klin Wochenschr 121(19–20):616–622CrossRefPubMed Lesic I, Maurer E, Strippoli MP, Kuehni CE, Barbato A, Frischer T (2009) Primary ciliary dyskinesia (Pcd) in Austria. Wien Klin Wochenschr 121(19–20):616–622CrossRefPubMed
21.
go back to reference Storm van’s Gravesande K, Omran H (2005) Primary ciliary dyskinesia: clinical presentation diagnosis and genetics. Ann Med 37(6):439–449CrossRefPubMed Storm van’s Gravesande K, Omran H (2005) Primary ciliary dyskinesia: clinical presentation diagnosis and genetics. Ann Med 37(6):439–449CrossRefPubMed
22.
go back to reference Stannard W, O’Callaghan C (2006) Ciliary function and the role of cilia in clearance. J Aerosol Med 19(1):110–115CrossRefPubMed Stannard W, O’Callaghan C (2006) Ciliary function and the role of cilia in clearance. J Aerosol Med 19(1):110–115CrossRefPubMed
23.
go back to reference Pedersen M, Mygind N (1982) Rhinitis, sinusitis and otitis media in Kartagener’s syndrome (primary ciliary dyskinesia). Clin Otolaryngol Allied Sci 7(6):373–380CrossRefPubMed Pedersen M, Mygind N (1982) Rhinitis, sinusitis and otitis media in Kartagener’s syndrome (primary ciliary dyskinesia). Clin Otolaryngol Allied Sci 7(6):373–380CrossRefPubMed
24.
go back to reference Mygind N, Pedersen M (1983) Nose-, sinus- and ear-symptoms in 27 patients with primary ciliary dyskinesia. Eur J Respir Dis Suppl 127:96–101PubMed Mygind N, Pedersen M (1983) Nose-, sinus- and ear-symptoms in 27 patients with primary ciliary dyskinesia. Eur J Respir Dis Suppl 127:96–101PubMed
25.
go back to reference Paradise JL, Feldman HM, Campbell TF, Dollaghan CA, Colborn DK, Bernard BS, Rockette HE, Janosky JE, Pitcairn DL, Sabo DL, Kurs-Lasky M, Smith CG (2001) Effect of early or delayed insertion of tympanostomy tubes for persistent otitis media on developmental outcomes at the age of three years. N Engl J Med 344(16):1179–1187CrossRefPubMed Paradise JL, Feldman HM, Campbell TF, Dollaghan CA, Colborn DK, Bernard BS, Rockette HE, Janosky JE, Pitcairn DL, Sabo DL, Kurs-Lasky M, Smith CG (2001) Effect of early or delayed insertion of tympanostomy tubes for persistent otitis media on developmental outcomes at the age of three years. N Engl J Med 344(16):1179–1187CrossRefPubMed
26.
go back to reference Majithia A, Fong J, Hariri M, Harcourt J (2005) Hearing outcomes in children with primary ciliary dyskinesia—a longitudinal study. Int J Pediatr Otorhinolaryngol 69(8):1061–1064CrossRefPubMed Majithia A, Fong J, Hariri M, Harcourt J (2005) Hearing outcomes in children with primary ciliary dyskinesia—a longitudinal study. Int J Pediatr Otorhinolaryngol 69(8):1061–1064CrossRefPubMed
27.
go back to reference van der Baan S (1991) Primary ciliary dyskinesia and the middle ear. Laryngoscope 101(7 Pt 1):751–754PubMed van der Baan S (1991) Primary ciliary dyskinesia and the middle ear. Laryngoscope 101(7 Pt 1):751–754PubMed
28.
go back to reference Turner JA, Corkey CW, Lee JY, Levison H, Sturgess J (1981) Clinical expressions of immotile cilia syndrome. Pediatrics 67(6):805–810PubMed Turner JA, Corkey CW, Lee JY, Levison H, Sturgess J (1981) Clinical expressions of immotile cilia syndrome. Pediatrics 67(6):805–810PubMed
29.
go back to reference Hadfield PJ, Rowe-Jones JM, Bush A, Mackay IS (1997) Treatment of otitis media with effusion in children with primary ciliary dyskinesia. Clin Otolaryngol Allied Sci 22(4):302–306CrossRefPubMed Hadfield PJ, Rowe-Jones JM, Bush A, Mackay IS (1997) Treatment of otitis media with effusion in children with primary ciliary dyskinesia. Clin Otolaryngol Allied Sci 22(4):302–306CrossRefPubMed
30.
go back to reference Baroody FM (2007) Mucociliary transport in chronic rhinosinusitis. Clin Allergy Immunol 20:103–119PubMed Baroody FM (2007) Mucociliary transport in chronic rhinosinusitis. Clin Allergy Immunol 20:103–119PubMed
31.
go back to reference Bush A, Chodhari R, Collins N, Copeland F, Hall P, Harcourt J, Hariri M, Hogg C, Lucas J, Mitchison HM, O’Callaghan C, Phillips G (2007) Primary ciliary dyskinesia: current state of the art. Arch Dis Child 92(12):1136–1140CrossRefPubMed Bush A, Chodhari R, Collins N, Copeland F, Hall P, Harcourt J, Hariri M, Hogg C, Lucas J, Mitchison HM, O’Callaghan C, Phillips G (2007) Primary ciliary dyskinesia: current state of the art. Arch Dis Child 92(12):1136–1140CrossRefPubMed
32.
go back to reference Barghouth G, Prior JO, Lepori D, Duvoisin B, Schnyder P, Gudinchet F (2002) Paranasal sinuses in children: size evaluation of maxillary sphenoid, and frontal sinuses by magnetic resonance imaging and proposal of volume index percentile curves. Eur Radiol 12(6):1451–1458CrossRefPubMed Barghouth G, Prior JO, Lepori D, Duvoisin B, Schnyder P, Gudinchet F (2002) Paranasal sinuses in children: size evaluation of maxillary sphenoid, and frontal sinuses by magnetic resonance imaging and proposal of volume index percentile curves. Eur Radiol 12(6):1451–1458CrossRefPubMed
33.
go back to reference Rollin M, Seymour K, Hariri M, Harcourt J (2009) Rhinosinusitis symptomatology and absence of polyposis in children with primary ciliary dyskinesia. Rhinology 47(1):75–78PubMed Rollin M, Seymour K, Hariri M, Harcourt J (2009) Rhinosinusitis symptomatology and absence of polyposis in children with primary ciliary dyskinesia. Rhinology 47(1):75–78PubMed
34.
go back to reference Parsons DS, Greene BA (1993) A treatment for primary ciliary dyskinesia: efficacy of functional endoscopic sinus surgery. Laryngoscope 103(11 Pt 1):1269–1272PubMed Parsons DS, Greene BA (1993) A treatment for primary ciliary dyskinesia: efficacy of functional endoscopic sinus surgery. Laryngoscope 103(11 Pt 1):1269–1272PubMed
35.
go back to reference Wei YX, Xing FH, Miao XT, Liu XC, Zhang X, Lin J, Sun YL, Han DM (2007) Clinical features of primary ciliary dyskinesia. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 42(3):195–198PubMed Wei YX, Xing FH, Miao XT, Liu XC, Zhang X, Lin J, Sun YL, Han DM (2007) Clinical features of primary ciliary dyskinesia. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 42(3):195–198PubMed
Metadata
Title
ENT manifestations in patients with primary ciliary dyskinesia: prevalence and significance of otorhinolaryngologic co-morbidities
Authors
J. Ulrich Sommer
Kerstin Schäfer
Heymut Omran
Heike Olbrich
Julia Wallmeier
Andreas Blum
Karl Hörmann
Boris A. Stuck
Publication date
01-03-2011
Publisher
Springer-Verlag
Published in
European Archives of Oto-Rhino-Laryngology / Issue 3/2011
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-010-1341-9

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