Symptom outcome after functional endoscopic sinus surgery in patients with cystic fibrosis: A prospective study

Abstract

Twenty-nine consecutive patients with cystic fibrosis were offered functional endoscopic sinus surgery. Twenty-six of these patients underwent surgery. A symptom questionnaire was obtained from the patient or parent before surgery. At the end of the study this symptom questionnaire was again administered to the same individual, and 21 completed it. There were 14 male and 7 female patients, with a mean age of 12.3 years and a median age of 8.7 years. Mean follow-up was 34.3 months. Results for the following symptoms were significant: nasal airway obstruction was improved (p < 0.0002), olfactory function was improved (p < 0.0037), purulent nasal discharge was decreased (p < 0.001), and activity level was increased (p < 0.001). Other parameters are also reported in the text. In summary, this study prospectively studies the effects of functional endoscopic sinus surgery on symptoms in patients with cystic fibrosis. The study points out several significant areas of symptom improvement and supports the selective use of functional endoscopic sinus surgery in patients with cystic fibrosis. Indications for surgery are provided.

Medical and Surgical Advancements in the Management of Cystic Fibrosis Chronic Rhinosinusitis

“…122 Due to intrinsic defects in the sinonasal mucosa of CF patients, primary outcomes have traditionally focused on QOL measures based on improved symptoms of nasal airway obstruction, sinonasal purulence, sense of olfaction, and overall activity level. 123 Aside from symptomatic improvement, however, endoscopic appearance and pulmonary function testing (PFT) have been the next most commonly reported outcomes for measuring the efficacy of surgical intervention. 122 In the review by Liang et al, endoscopic improvements in CF-related CRS were evident in more than 50% of studies based on assessments of polyposis, edema, mucopurulence, crusting, and/or scarring.…”

Evolution and diversification of Pseudomonas aeruginosa in the paranasal sinuses of cystic fibrosis children have implications for chronic lung infection

“…Patient B42 also did not have recurrent colonizations after the second surgery until conclusion of the study in July 2009, and small reductions in lower airway colonization frequencies were seen for a couple of the other patients (Supplementary Table S1). These findings suggest that the sinus populations are intermittently seeding the lower airways, and that removal of these may offer a temporary relief of sinus symptoms and possibly lung colonization events (HK Johansen, personal communication; Jones et al, 1993;Nishioka et al, 1995). On the basis of colony morphology and other phenotypic characteristics, we have constructed a model for a tentative development of the sinus populations of P. aeruginosa in patient B22 (Figure 4).…”

Cystic Fibrosis Chronic Rhinosinusitis: A Comprehensive Review

“…61,62 Other symptoms include facial pain, activity intolerance, halitosis, and voice changes. [63][64][65] When associated with nasal CRS with NPs, the most common complaint is nasal obstruction whereas in patients without NPs, the most common complaint is headache or facial pain. 25 Mouth breathing coupled with thick anterior and posterior nasal discharge may be the result of sinonasal polyposis.…”