TRIO Best Practice articles are brief, structured reviews designed to provide the busy clinician with a handy outline and reference for day-to-day clinical decision making. The ENTtoday summaries below include the Background and Best Practice sections of the original article. To view the complete Laryngoscope articles free of charge, visit Laryngoscope.com.
Explore this issue:April 2017
Cystic fibrosis (CF) is the most common autosomal recessive disease in the Caucasian population, with an estimated incidence of 1:2500 to 1:3000 among newborns. In patients with CF, there is a defect in chloride ion transport resulting in a reduction in the water content of secretions. The more viscous mucus impairs normal mucociliary patterns and causes mechanical obstruction of the paranasal sinuses. The prevalence of sinus disease in patients with CF is estimated to be between 90% and 100%, with nasal polyposis occurring in up to two-thirds of CF patients. Given that sinonasal disease affects nearly all CF patients, appropriate treatment is a critical concern. This review describes the evidence regarding endoscopic sinus surgery (ESS) in patients with CF.
The current evidence suggests that ESS improves sinonasal symptoms and QoL in patients with CF. Data also suggest that ESS decreases IHDs. There is more conflicting evidence regarding its impact on the need for IV antibiotics. The literature regarding the impact of ESS on lower airway disease is also conflicting, with most recent studies showing no significant improvement in PFTs. Higher-level studies are necessary to determine if there is a benefit of ESS for lower airway disease (Laryngoscope. 2015;125: 2018–2020).