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Pulmonary aspiration of sinus secretions in patients with cystic fibrosis
Author(s) -
Nelson Jacob,
Karempelis Peter,
Dunitz Jordan,
Hunter Ryan,
Boyer Holly
Publication year - 2018
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.22043
Subject(s) - medicine , cystic fibrosis , sinusitis , lung , respiratory disease , pulmonary aspiration , gastroenterology , pulmonary function testing , pathology , surgery
Background Indirect evidence suggests that sinonasal secretions are aspirated into the lungs of patients with cystic fibrosis (CF), contributing to infection, subsequent tissue damage, and decreased lung function. Our objective is to determine whether sinonasal secretions are transferred to the lungs in patients with CF‐related sinus disease and healthy subjects, particularly in the recumbent position and during sleep. Methods We performed a prospective, controlled trial to detect pulmonary aspiration of radiolabeled albumin applied to the nasal mucosa of study subjects with chronic sinusitis related to CF and control subjects without sinus disease. Radioactive counts were measured in the lungs and compared to background counts in both groups after 8 hours of rest/sleep. Results Complete data was collected on 12 CF patients and 6 controls. Eleven patients with CF demonstrated higher lung counts than background counts. The average counts of radiolabeled albumin in the lungs of CF patients were significantly greater than background counts ( p = 0.03). Controls did not demonstrate this finding ( p > 0.90), with only one‐half demonstrating lung counts greater than background counts. Conclusion This study provides direct evidence of aspiration of sinonasal secretions into the lungs of patients with CF and healthy adults in the recumbent position. The fact that both patients and controls aspirated secretions suggests that aspiration alone does not account for the pathogenesis of lung disease in CF patients.