The Risks of Complications During Endoscopic Sinus Surgery in Cystic Fibrosis Patients: An Anatomical and Endoscopic Study

2021 ◽  
Author(s):  
Giandomenico Maggiore ◽  
Michele Pietragalla ◽  
Christian De Amicis ◽  
Cosimo Nardi ◽  
Chiara Bruno ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Endoscopic Study

scholarly journals Chronic rhinosinusitis in adult patients with cystic fibrosis: clinical manifestation and therapeutic approaches

2019 ◽  
Vol 29 (3) ◽  
pp. 311-320
Author(s):  
G. L. Shumkova ◽  
E. L. Amelina ◽  
V. M. Svistushkin ◽  
E. V. Sin’kov ◽  
S. A. Krasovskiy ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Adult Patients ◽  
Sinus Surgery ◽  
Markers Of Inflammation

The aim of this study was to evaluate prevalence of chronic rhinosinusitis (CRS) and nasal polyps in adult patients with cystic fibrosis (CF) in Russian Federation. Additionally, we investigated the clinical course of CRS and developed the optimal therapeutic strategy.Methods. Three hundred and forty eight CF patients were involved in the study. Physical examination, computed tomography (CT) of paranasal sinuses and audiometry, if needed, were used. CRS and bilateral nasal polyps were diagnosed in 28 patients. Nasal endoscopy, SNOT-20 questionnaire, rhinomanometry, micro - biological examination of sputum and mucus from paranasal sinuses (obtained during puncture or surgery), spirometry, and measurement of serum markers of inflammation were used. Endoscopic sinus surgery was used in 14 patients (the group 1) and others were treated non-surgically (the group 2). Both group were treated during 6 months using intranasal mometasone, mucolytics and antibiotics via PARI SINUSTM nebulizer.Results. An improvement in symptoms, CT signs, rhinomanometry parameters and endoscopic signs was seen in both groups after treatment and was more prominent in the surgical treatment group compared to the non-surgical treatment group. Bacterial load reduction in nasal sinuses, decrease in the rate of pulmonary disease exacerbations, and an improvement in oxygen blood saturation were found in the surgical treatment group only. Treatment of CRS did not affect lung function, sputum microbiology and serum inflammatory markers.Conclusion. Endoscopic sinus surgery followed by intranasal mucolytics and antibacterials is an effective and well-tolerated treatment in adult CF patients with CRS. 

Office-Based Sinus Surgery for Cystic Fibrosis Chronic Rhinosinusitis

ORL ◽  
2020 ◽  
pp. 1-4
Author(s):  
Daniel B. Spielman ◽  
David A. Gudis
Keyword(s):  
Cystic Fibrosis ◽  
Mechanical Ventilation ◽  
Chronic Rhinosinusitis ◽  
Local Anesthesia ◽  
Endoscopic Sinus Surgery ◽  
Care Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Sinus Surgery ◽  
Office Setting

<b><i>Objective:</i></b> Chronic rhinosinusitis (CRS) is nearly ubiquitous in the cystic fibrosis (CF) population, and many patients require multiple endoscopic sinus surgeries throughout their lifetime. Recent studies have demonstrated the profound pulmonary and systemic health benefits of comprehensive CRS treatment. Both endotracheal intubation with mechanical ventilation and inpatient hospital care represent significant risks for CF patients. The goal of this study is to evaluate the safety and feasibility of performing revision endoscopic sinus surgery for CF patients in the outpatient office setting using only local anesthesia to decrease the need for mechanical ventilation and inpatient hospitalization. <b><i>Methods:</i></b> This is a prospective cohort study conducted at a tertiary care academic medical center with a CF Foundation-accredited care center. Patients with CF and refractory CRS despite prior surgery and medical therapy were eligible for inclusion. Comprehensive revision ESS was performed in the office using only local anesthesia. <b><i>Results:</i></b> Five patients were enrolled and underwent revision endoscopic sinus surgery without complication. The average preoperative Sinonasal-Outcome Test-22 score was 52.0 ± 12.1 and the average preoperative Lund-Mackay score was 15.2 ± 3.8. No patients requested aborting the procedure early due to pain, discomfort, or any other reason. No subjects required prolonged observation or postoperative hospital admission. <b><i>Conclusion:</i></b> This prospective pilot study is the first to demonstrate the safety and feasibility of performing comprehensive revision endoscopic sinus surgery for CF patients in the outpatient office setting using only local anesthesia.

Paranasal Sinus Mucoceles in Cystic Fibrosis

1993 ◽  
Vol 7 (1) ◽  
pp. 31-35 ◽  
Author(s):  
William E. Davis ◽  
Giulio J. Barbero ◽  
William R. LaMear ◽  
Jerry W. Templer ◽  
Peter Konig
Keyword(s):  
Cystic Fibrosis ◽  
Paranasal Sinus ◽  
Computerized Tomography ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
The Other ◽  
Sinus Surgery ◽  
Lateral Nasal Wall ◽  
Osteomeatal Complex

Six patients between the ages of 6 and 22 years old with cystic fibrosis were found to have mucoceles of the paranasal sinuses. Four were male and two were female. They experienced nasal obstruction, purulent rhinorrhea, and anosmia, but none had fever or pain. Nasal endoscopy and coronal computerized tomography scans revealed the lateral nasal wall to be displaced medially against the septum. Functional endoscopic sinus surgery revealed large cystic spaces filled with thick yellow-green mucus. Postoperatively most patients are able to smell and breathe through their noses. The mucocele probably begins as an obstructed anterior ethmoid cell, which then enlarges and obstructs the osteomeatal complex, which further impairs drainage of the other sinuses into this area.

scholarly journals Endoscopic sinus surgery in patients with cystic fibrosis: a systematic review and meta-analysis of pulmonary function

2012 ◽  
Vol 50 (4) ◽  
pp. 360-369
Author(s):  
K.I. Macdonald ◽  
A. Gipsman ◽  
A. Magit ◽  
M. Fandino ◽  
E. Massoud ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cystic Fibrosis ◽  
Pulmonary Function ◽  
Endoscopic Sinus Surgery ◽  
Meta Analysis ◽  
Pulmonary Function Tests ◽  
Sinus Surgery ◽  
Intravenous Antibiotics

Introduction: The role of endoscopic sinus surgery (ESS) in patients with cystic fibrosis (CF) is not clearly defined. Objective: TO perform a systematic review of subjective and objective outcomes of ESS in CF. Methods: A systematic review was performed using the keywords 'sinusitis,' 'sinus surgery,' 'nasal polyps' and 'cystic fibrosis.' The quality of papers was assessed using the NICE scoring scale. Outcomes included safety, subjective symptoms, objective endoscopy scores, days spent in hospital, courses of antibiotics, and pulmonary function tests (PFTs). Results: Nineteen studies involving 586 patients were included in the review. There were four prospective cohort trials, and three were rated as good quality. There were no major complications attributable to ESS. There was consistent evidence in four cohort studies of improved sinonasal symptoms, including nasal obstruction, facial pain, headaches, rhinorrhea and olfaction. Three studies reported conflicting results in post-operative endoscopy scores. Three studies showed a decrease in days spent in hospital, and two showed a significant decrease in courses of intravenous antibiotics. A recent study, however, did not show a difference in either days spent in hospital or courses of antibiotics. Pulmonary function tests were not improved by ESS in six cohort trials, and one small study found significant improvement. A meta-analysis of FEV1 scores confirmed no significant difference. Conclusion: THE most consistent findings of this review were that ESS in patients with CF is safe, produces symptomatic benefit, and does not consistently improve PFTs. There were more conflicting results with regards to endoscopy scores, days spent in hospital, and courses of intravenous antibiotics. Future prospective studies, utilizing validated quality of life, symptom and endoscopy scales, are needed to further elucidate the role of ESS in the management of chronic rhinosinusitis in CF patients.

scholarly journals Endoscopic Sinus Surgery in Cystic Fibrosis: Effects on Pulmonary Function and Ideal Body Weight

2004 ◽  
Vol 83 (2) ◽  
pp. 118-121 ◽  
Author(s):  
William A. Jarrett ◽  
Oleg Militsakh ◽  
Michael Anstad ◽  
Jose Manaligod
Keyword(s):  
Cystic Fibrosis ◽  
Body Weight ◽  
Pulmonary Function ◽  
Endoscopic Sinus Surgery ◽  
Ideal Body Weight ◽  
Sinus Surgery ◽  
Ideal Body

Complete versus Limited Endoscopic Sinus Surgery for Chronic Rhinosinusitis in Adults with Cystic Fibrosis

2020 ◽  
Vol 162 (4) ◽  
pp. 572-580 ◽  
Author(s):  
Daniel J. Lee ◽  
Christopher M. K. L. Yao ◽  
Jenna Sykes ◽  
Leena Rizvi ◽  
Elizabeth Tullis ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Postoperative Period ◽  
Endoscopic Sinus Surgery ◽  
Hospital Admissions ◽  
Care Center ◽  
Sinus Surgery ◽  
Oral Antibiotic ◽  
Health Care Center ◽  
Pulmonary Exacerbations

Objective To examine the effects of the extent of endoscopic sinus surgery (ESS) on pulmonary health, including the pulmonary exacerbations and lung function in patients with cystic fibrosis (CF). Study Design Retrospective cohort study. Setting Tertiary health care center. Subjects and Methods A retrospective review of patients with CF who underwent ESS at St. Michael’s Hospital between 1999 and 2016 was performed. Two groups of patients were identified based on the surgical extent: (1) complete (maxillary antrostomy, complete ethmoidectomy, sphenoidotomy, and frontal sinusotomy) and (2) limited (any ESS that involved less than complete). Primary outcomes included the number of pulmonary exacerbations (the use of oral or intravenous [IV] antibiotics), number of hospital admissions and hospital days during a 2-year pre- and postoperative period, and pulmonary function outcomes during a 1-year pre- and postoperative period. Results There were 70 procedures (30 complete and 40 limited) among 57 patients. Baseline characteristics were similar between the groups. Complete ESS group had a significant reduction in the oral antibiotic use compared to the limited ESS group (median, –1.0 [interquartile range (IQR), –2 to 0] in complete vs 0 [IQR, –1 to 1] in limited, P = .028). There was no difference in the use of IV antibiotics, number and duration of admissions, or rate of lung function change between the 2 groups. Conclusion Complete ESS may reduce mild forms of pulmonary exacerbations as shown in the decreased use of oral antibiotics. Overall, ESS does not significantly modify pulmonary outcomes in patients with CF.

Endoscopic Sinus Surgery for Cystic Fibrosis: Variables Influencing Sinonasal and Pulmonary Outcomes

2021 ◽  
pp. 194589242110596
Author(s):  
Keven S. Y. Ji ◽  
Dennis Frank-Ito ◽  
Ralph Abi Hachem ◽  
Khalil Issa ◽  
Carrie Johnson ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pulmonary Function ◽  
Revision Surgery ◽  
Endoscopic Sinus Surgery ◽  
Stepwise Regression ◽  
Care Center ◽  
Tertiary Care ◽  
Forced Expiratory Volume ◽  
Older Age ◽  
Sinus Surgery

Background Endoscopic sinus surgery is a well-established treatment for chronic rhinosinusitis in patients with cystic fibrosis, though its benefits seem to be limited to improving sinonasal symptoms rather than affecting lung function. Objective This study aims to identify clinical and demographic factors that may influence sinonasal and pulmonary outcomes after surgery. Methods This is a six-year retrospective analysis of adult cystic fibrosis patients who underwent endoscopic sinus surgery at a tertiary care center. 22-Item Sino-Nasal Outcomes Test scores and mean forced expiratory volume data at baseline and three to six months after surgery were analyzed using t-test and stepwise regression with the following covariates: age, gender, lung transplant, revision surgery, and pseudomonas on sinus culture. Results 119 surgeries were performed on 88 patients, with 69% on patients with transplant. The overall mean (Standard Deviation) improvement in 22-Item Sino-Nasal Outcomes Test score was 9.42 (18.15) for the entire cohort ( P < .001). Pseudomonas on culture was associated with less improvement in sinonasal scores ( P = .002). There was no significant change in forced expiratory volume after surgery ( P = .94). Revision surgery ( P = .004) and older age ( P = .007) were associated with less favorable change of pulmonary function on stepwise regression ( P = .002). There was no correlation between change in sinonasal scores and pulmonary function. Conclusion Although surgery was associated with a clinically and statistically significant improvement in sinonasal scores in cystic fibrosis patients, patients with pseudomonas may experience less benefit. Revision surgery and older age may be associated with less favorable pulmonary outcomes. Awareness of such variables may help when deciding which cystic fibrosis patients should undergo surgery.

Bilateral Antrochoanal Polyp with Diabetes: A Rare Presentation of Cystic Fibrosis

2010 ◽  
Vol 3 (3) ◽  
pp. 173-176
Author(s):  
Monica Gupta ◽  
Manish Gupta
Keyword(s):  
Cystic Fibrosis ◽  
Endoscopic Sinus Surgery ◽  
English Literature ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Adolescent Male ◽  
Antrochoanal Polyp ◽  
Rare Presentation ◽  
First Case

Abstract Bilateral antrochoanal (AC) polyps have been rarely reported in english literature. Here we report the first case of an adolescent male with bilateral AC polyps, cystic fibrosis and diabetes. The case was managed successfully by functional endoscopic sinus surgery (FESS). The patient has been under follow-up for the last six months with no signs of recurrence.

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