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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 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 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．

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．

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1+·id!(5ý§"úâS.¦S)JOå
*;4+"]âá 2004%108$956(964.
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diagnostic approach for acute paranasal sinusitis
in children. Pediatr Infect Dis J 1996%15$576(579.
3+1ÂÈ!~xø!V!A"UR;@`úâysÊÿ S¸W"úâü 2005%58$1011(1014.
4+i¿!¼'£!nþòÆ"ysÊê R;@` B x'tNf)J"]çsÅ
 1989%92$1345(1353.
5+Savolainen S, Pietola M, Kiukaanniemi H, et al.
An ultrasound device in the diagnosis of acutemaxillary sinusitis. Acta Otolaryngol Suppl
1997%529$148(152.
6+Revonta M, Kuuliala I. The diagnosis and followup of pediatric sinusitis$Waters view radiography versus ultrasonography. Laryngoscope
1989%99$321(324.

º20³ 1 v 1 ²35')35*

7*²¼DTSI&ea"nj ÈÄ#jÂGENREV 2005"¬q$rÇl_!2005.
8*·DTSI&ÄGENREVX[a"·DTSI&ÄGENREV'¦³·\:^¹'2002 ³¶")b§£ 4 ¶*"¬q$REOKEFVL!2003.
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to primary care $ a prospective cohort study.
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13*»vµ´!« !¯xZ! "<d;/2B³Å©°¥"² 1987%91$
3788'3794.
14*Wald ER, Reilly JS, Casselbrant M, et al. Treatment of acute maxillary sinusitis in childhood$a
comparative study of amoxicillin and cefaclor. JPediatr 1984%104$297'302.
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in the common cold. J Allergy Clin Immunol
1998%102$403'408.
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20*cÁÄ;/2B{s¿ªÀ<6?<U&HVJJS&P"n®\/@=kÆh;¡5B{s¿ÀGENREV'67<¨W'"cÁ] 2005%8$57'84.
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The Frequency of Sinusitis Associated with Prolonged Coughing in Children
Tatsuo Nishimura
Nishimura 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 physician at Nishimura pediatric clinic between January and December 2005, and demonstrated coughing persisting 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 sinus
was 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$The coughing group consisted of 57 children (27 boys and 30 girls), aged 5.81+1.69 years old(mean+SD), duration of coughing was 18.1+8.1days. Sinus echo was positive and 34 cases (59.6-) were diagnosed as having sinusitis. The control group was comprised of 38 children (18 boys and 20 girls), aged 5.16+
1.95 years old, and sinus echo was positive in only one child in this group. There was a significant difference in
the incidence of sinusitis between the coughing group and the control group (p,0.01).
Among the 34 sinusitis-positive children in the coughing group, there were 17 boys and 17 girls, aged
5.44+1.44 years old. Among 23 cases showing negative findings, there were 10 boys and 13 girls, aged 6.35+
1.92 years old. Acute otitis media developed in 6 cases (17.6-) and otitis media with effusion developed 6 cases(17.6-) during the clinical course in the sinusitis-positive group. One case (4.3-) of acute otitis media and 2cases of otitis media with effusion developed in the group with negative findings. Allergic airway disease suchas allergic rhinitis or bronchial asthma was found in 9 cases (26.5-) in the sinusitis positive group and 10 case(43.5-) in the sinusitis-negative group.
Conclusions$There are many cases of sinusitis among pediatric patients with symptoms of prolonged
coughing and ultrasound examination of the maxillary antrum back wall echo are useful for diagnosis.