Outcomes of sinus surgery in adults with cystic fibrosis

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-lifie 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. (C) 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.