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Existen suficientes pruebas de una conexión epidemiológica, etiológica y fisiopatológica entre la rinitis crónica, en la mayoría de los casos de etiología alérgica, y el asma, así como entre la sinusitis crónica, por lo general bacteriana, y esta misma enfermedad. La inflamación alérgica de la mucosa nasal podría favorecer el desarrollo de una sinusitis crónica propiamente dicha. De hecho, algunos autores piensan que debería hablarse de “rinosinusitis” puesto que se trata de la misma mucosa. Algunos estudios demuestran que el control terapéutico tanto de la rinitis como de la sinusitis crónicas produce una mejoría en la evolución del asma cuando ambas entidades clínicas se observan en el mismo enfermo, por lo que también existe una conexión terapéutica. Por otra parte, no existen pruebas suficientes de que la adenoidectomía y/o la amigdalectomía empeore la evolución del asma. En el tratamiento del niño asmático debe prestarse también atención a la vía superior y evaluar y tratar la enfermedad de esta zona, sabiendo que este control redundará en un beneficio del control de la propia asma.
Palabras clave:
Asma
Rinitis
Sinusitis
Vía respiratoria superior
Adenoidectomía
Amigdalectomía
There is enough evidence of an epidemiological, etiological and physiopathological link between chronic rhinitis (usually allergic) and asthma, and also between chronic sinusitis (generally bacterial) and this disease. Allergic inflammation of nasal mucosa could favor the development of chronic sinusitis. Indeed, some authors believe that the term “rhinosinusitis” should be used as nasal and sinus mucosa are one and the same thing. Some studies have demonstrated that treatment of chronic rhinitis or chronic sinusitis produces a benefit in the evolution of asthma when both diseases co-occur in the same patient, which suggests a therapeutic link. However, there is insufficient evidence that adenoidectomy and/or tonsillectomy worsen the evolution of asthma. When managing the asthmatic child, physicians should not forget to pay attention to the upper respiratory tract, evaluating and treating diseases in this area if necessary, as such therapeutic measures will also benefit asthma control.
Key words:
Asthma
Rhinitis
Sinusitis
Upper respiratory tract
Adenoidectomy
Tonsillectomy
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