Open AccessChronic rhinosinusitis in adult patients with cystic fibrosis: clinical manifestation and therapeutic approaches
Author(s) -
Г. Л. Шумкова,
Е. Л. Амелина,
В. М. Свистушкин,
Э. В. Синьков,
С. А. Красовский,
М. В. Афанасьева,
С. В. Поликарпова,
М Ю Чернуха,
Л Р Аветисян,
И А Шагинян
Publication year - 2019
Publication title -
pulʹmonologiâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.126
H-Index - 6
eISSN - 2541-9617
pISSN - 0869-0189
DOI - 10.18093/0869-0189-2019-29-3-311-320
Subject(s) - medicine , cystic fibrosis , sputum , paranasal sinuses , chest physiotherapy , nasal administration , mucociliary clearance , rhinomanometry , surgery , spirometry , functional endoscopic sinus surgery , antibiotics , nose , sinusitis , lung , pathology , tuberculosis , asthma , microbiology and biotechnology , immunology , biology
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.