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Effect of endoscopic sinus surgery on clinical outcomes in DeltaF508 cystic fibrosis patients
Author(s) -
Dadgostar Anali,
Nassiri Sepehr,
Quon Bradley S.,
Manji Jamil,
Alsalihi Salahuddin,
Javer Amin
Publication year - 2021
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.13751
Subject(s) - medicine , exacerbation , cystic fibrosis , pulmonary function testing , chronic rhinosinusitis , population , retrospective cohort study , lung function , surgery , lung , environmental health
Objectives Chronic rhinosinusitis (CRS) is prevalent in the Cystic Fibrosis (CF) population. CRS exacerbations in CF are thought to contribute to pulmonary exacerbations. Literature regarding the impact of endoscopic sinus surgery (ESS) is inconclusive. This study examines rates of lung function decline and pulmonary exacerbation in CF patients who have undergone ESS. Design Retrospective review of medical records. Setting Academic Hospital. Participants 40 adult CF patients. Main outcome measures Rate of lung function decline (% predicted Forced Expiratory Volume in 1 second [ppFEV 1 ]), number of pulmonary exacerbations (IV/oral antibiotic therapy ± hospital admission) and total number days hospitalised 2‐year postoperatively was collected. CRS patients undergoing ESS were matched to those without ESS by gender, age, and F508del genotype. Results Forty patients (mean age 37.4, 60% male) were reviewed. No significant difference was found between the surgical group and controls in baseline ppFEV 1 (72.5% vs. 72.7%, P = .98), 2‐year preoperative number of pulmonary exacerbations (3.05 vs. 1.65, P = .10), or Lund‐Mackay scores (12.25 vs. 11.55, P = .71). No significant difference was found in 1‐year (70.5% vs. 72.8%, P = .84) or 2‐year (70.4% vs. 72.6% P = .80) postoperative ppFEV 1 and 2‐year postoperative pulmonary exacerbations (1.7 vs. 1.45, P = .87). A significant increase was identified in total number days hospitalised postoperatively (4.85, P = .02). In the surgical group, no significant difference was identified between preoperative and postoperative ppFEV 1 , 1 year (−2.51%, P = .32) and 2 years after ESS (−3.10%, P = .51), postoperative rate of pulmonary exacerbations (−1.28, P = .11), or in total number days hospitalised (3.74, P = .14). Conclusions In this study, ESS does not appear to significantly improve ppFEV 1 or decrease the number of pulmonary exacerbations postoperatively.