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. 2008 Jan 3;7(4):219–223. [Article in French] doi: 10.1016/S1294-5501(05)80454-6

Facteurs infectieux et non infectieux des otites et des sinusites

Infectious and non infectious factors in otitis media and in sinusitis

B Barry 1,⁎
PMCID: PMC7146782  PMID: 32288530

Abstract

Les infections de la sphère ORL sont fréquentes et les otites chez l’enfant, les sinusites de l’adulte sont généralement perçues comme étant d’origine bactérienne ou virale. Cependant de nombreux facteurs non infectieux jouent un rôle non négligeable, mais restent souvent méconnus et d’interprétation difficile : ils conduisent encore trop souvent à des thérapeutiques antibiotiques inutiles. Ainsi dans l’otite, ont été reconnus divers facteurs de risque non infectieux tels que : atteinte mécanique de la trompe d’Eustache, immaturité immunitaire, tabagisme passif, carence martiale etc… susceptibles de favoriser l’infection de l’oreille moyenne, souvent virale dans un 1er temps, secondairement surinfectée par les espèces bactériennes du rhinopharynx ((pneumocoques, Haemophilus influenzae, Moraxella catarrhalis). Les sinusites sont d’étiologie multifactorielle et, si les mécanismes et les agents des sinusites infectieuses (virus et bactéries) sont bien connus, en revanche de multiples facteurs non infectieux peuvent être identifiés : l’allergie est un facteur fréquent qui favorise les sinusites à répétition ; moins souvent reconnus sont le diabète, le reflux gastro-oesophagien, des facteurs anatomiques, des anomalies de la fonction muco-ciliaire ou l’immunodépression dans le cadre VIH. Des recherches doivent être poursuivies pour approfondir ces mécanismes complexes.

Mots-clés: Otites, sinusites, virus, bactéries, infections, facteurs non infectieux

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