Outcomes of Sinus Surgery in Adults with Cystic Fibrosis

Abstract

OBJECTIVES: Adults with cystic fibrosis (CF) represent a challenging subset of patients with chronic rhinosinusitis (CRS). While data suggest that endoscopic sinus surgery (ESS) may benefit pediatric CF patients, there remains a paucity of data regarding the impact of endoscopic sinus surgery on adult CF patients with CRS. Our purpose was to evaluate objective and quality-of-life measures in adult CF patients with CRS following ESS. STUDY DESIGN: Nested case-control study. SETTING: Tertiary care center. METHODS: Twenty patients with CF were evaluated and matched to 20 controls without concomitant CF. Preoperative CT and preoperative/postoperative endoscopic findings were recorded as objective measures. Changes in two disease-specific quality-of-life (QoL) instruments were also evaluated both preoperatively and postoperatively. RESULTS: Mean postoperative follow-up was similar for cases and controls (13.1 ± 7.9 months vs 14.0 ± 6.0 months, respectively). Preoperative CT scores (16.9 ± 4.5 vs 10.9 ± 5.9, P = 0.001) and endoscopy scores (9.3 ± 5.8 vs 5.7 ± 4.6, P = 0.049) were significantly worse in CF patients. Postoperative endoscopy scores were significantly worse for CRS patients with CF ( P = 0.001), although the degree of improvement on endoscopy within each group was no different ( P = 0.071). Additionally, both groups experienced similar improvement in QoL after ESS (all P ≥ 0.134). CONCLUSIONS: While baseline measures of disease severity are worse in the CF population, our data support objective and QoL improvements for adult patients with comorbid CF comparable to patients without CF.