Missed diagnosis and treatment discussion of Kartagener syndrome].

To investigate the clinical feature and diagnostic criteria of Kartagener syndrome, and related treatment of sinusitis and nasal polyps. The clinical data of 5 patients which were diagnosed as complete Kartagener syndromen in The forth hosipital of Hebei medical university were analyzed retrospectively. The first symptom of these patients was sinusitis. All of them accepted cardiac apical auscultation, X ray of orthophoria chest film and chest CT plain scan examination before diagnosis. All of them were treated intervention therapy in outpatient department,and 1 case accepted endoscopic sinus surgery in the hospital. The analysis of the data was to investigate the diagnosis in outpatient department and the perioperative therapy effect. All of the 5 patients' clinical feature were total mirror situs inversus viscerum, Dexcrocardia and brochiectasis associated with infection, "signet ring sign", "tram line sign", "honeycomb sign" at different degree on chest CT, bilateral maxillary and ethmoidal sinus inflammation on sinus CT. All the 5 patients appeared bilateral secretor otitis media associated with conductive deafness at different degree. 4 cases accepted anti-inflammation,mucus diluted and medicine treatment to improve cilia activity. 1 case accepted medicine and endoscopic sinus operation for obvious nasal symptoms. After following up for years,all symptoms of the 5 patients relieved, so did recurrent bronchiectasis infection. 1 case with operation had obviously relieved symptom and no postoperative complication. Although complete Kartagener syndrome is infrequent disease, heart auscultation diagnosis and image examination are effective method to reduce missed diagnosis. Symptomatic treatment and suitable endoscopic sinus surgery method can reduce sinus symptom and the infection possibility of bronchiectasis effectively,which is beneficial for KS outcome.

Citation

Shun Gao, Ruili Zhao, Qin Xu. Missed diagnosis and treatment discussion of Kartagener syndrome]. Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery. 2013 Jan;27(2):61-4

PMID: 23650700

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