Importance to question sinonasal symptoms and to perform rhinoscopy and rhinomanometry in cystic fibrosis patients

Abstract

Among SNOT-20 scores the PNS subscore is related to rhinoscopically detected polyposis and sinonasal secretion. Therefore, we recommend including short questions regarding PNS into CF-routine care. At the same time our results show that a high inspiratory airflow is not associated with a good sensation of nasal patency. Altogether, rhinomanometry is not required within routine CF-care, but it can be interesting as an outcome parameter within clinical trials. Pediatr Pulmonol. 2017;52:167-174. © 2016 Wiley Periodicals, Inc.

Ivacaftor improves rhinologic, psychologic, and sleep‐related quality of life in G551D cystic fibrosis patients

“…Several previous studies have identified an overall low sinonasal symptom burden in the CF population with some reporting that less than 10% of CF patients report significant sinonasal symptoms, despite the presence of significant objective disease . QOL questionnaires, such as SNOT‐20 and SNOT‐22, have corroborated this finding, with studies reporting average SNOT‐20/22 scores in the CF population to be around 15 to 20, similar to what was found in this cohort of patients . It has been suggested that this is related to these patients lack of a “normal” baseline for comparison.…”

“…It has been suggested that this is related to these patients lack of a “normal” baseline for comparison. Others have proposed that sinonasal symptoms are reported to be low because they are overshadowed by other systemic symptoms, such as significant pulmonary and/or gastrointestinal symptoms . Regardless of the exact reasoning as to why CF patients do not report a high level of sinonasal morbidity, the low symptom burden in these patients makes the assessment of response to treatment difficult.…”

Clinical predictors of cystic fibrosis chronic rhinosinusitis severity

“…Other radiographic findings of upper airway disease include sinus opacification, mucosal edema, mucoceles, medial bulging of the maxillary walls, polyposis, and chronic osteitis . As would be expected from the radiographic evidence of chronic inflammation, patients with CF‐CRS exhibit mucosal edema, crusting, and purulent discharge . Both radiographically and on physical exam, CF is marked by evidence of severe, chronic rhinosinusitis (CRS) in nearly all individuals.…”

Features of defeat of ent organs at adult patients with CF

“…При осмотре пациента выявляется деформация лицевого скелета, расширение корня носа, проптоз [5,9,31]. Передняя риноскопия и эндоскопическое исследование позволяет выявить застой и гиперемию слизистой оболочки полости носа, количество и характер отделяемого из носа (серозное, слизистое, гнойное, кровянистое) и локализовать место поступления отделяемого в полость носа, при выявлении полипов определить их характер и размер, диагностировать медиальное выпячивание латеральной стенки полости носа [9][10][11][35][36][37].…”

“…Наличие аплазии лобных пазух, а также затемнения верхнечелюстных и решетчатых пазух более чем в 75% случаев были оценены как патогномоничный симптом МВ. Присутствие горизонтальных уровней жидкости в пазухах у данных пациентов очень редко, возможно, вследствие длительного течения заболевания и очень высокой вязкости слизи, которая заполняет полностью околоносовые пазухи [5,21,34,35,[37][38][39]. Большинство пациентов с МВ имеют сниженное обоняние, которое полностью отсутствует у 8,6% [40].…”