Clinical effects of sinus surgery and adjuvant therapy in cystic fibrosis patients - can chronic lung infections be postponed?

• Published in: Rhinology Vol. 51; no. 3; pp. 222 - 230
• Main Authors: Aanaes, K, Johansen, H K, Skov, M, Buchvald, F F, Hjuler, T, Pressler, T, Hoiby, N, Nielsen, K G, von Buchwald, C
• Format: Journal Article
• Language: English
• Published: Netherlands 01-09-2013
• Subjects: Achromobacter - isolation & purification; Adolescent; Adult; Analysis of Variance; Anti-Bacterial Agents - therapeutic use; Bronchoalveolar Lavage; Burkholderia cepacia complex - isolation & purification; Burkholderia Infections - drug therapy; Burkholderia Infections - microbiology; Burkholderia Infections - surgery; Child; Chronic Disease; Combined Modality Therapy; Cystic Fibrosis - complications; Cystic Fibrosis - microbiology; Enzyme-Linked Immunosorbent Assay; Female; Gram-Negative Bacterial Infections - drug therapy; Gram-Negative Bacterial Infections - microbiology; Gram-Negative Bacterial Infections - surgery; Humans; Male; Middle Aged; Paranasal Sinuses - microbiology; Paranasal Sinuses - surgery; Prospective Studies; Pseudomonas aeruginosa - isolation & purification; Pseudomonas Infections - drug therapy; Pseudomonas Infections - microbiology; Pseudomonas Infections - surgery; Quality of Life; Rhinitis - drug therapy; Rhinitis - microbiology; Rhinitis - surgery; Sinusitis - drug therapy; Sinusitis - microbiology; Sinusitis - surgery; Spirometry; Surveys and Questionnaires; Therapeutic Irrigation; Treatment Outcome
• ISSN: 0300-0729
• DOI: 10.4193/Rhin12.207

The paranasal sinuses can be a bacterial reservoir for pulmonary infections in patients with cystic fibrosis (CF) METHODOLOGY: In this prospective, non-randomised, uncontrolled, intervention cohort study, the clinical effect of sinus surgery followed by two weeks` intravenous antibiotics, 6 months` antibiotic nasal irrigations was assessed in 106 CF patients.
One year after sinus surgery, the prevalence of intermittently colonised patients had decreased by 38%, while the prevalence of non-colonised patients had increased by 150%. The frequency of pulmonary samples with CF pathogens was reduced after surgery. Specific IgG against P. aeruginosa decreased after six months. Additionally, the self reported symptoms of chronic rhinosinusitis and quality of life improved.
Combined sinus surgery and postoperative systemic and topical antibiotic treatment significantly reduced the frequency of pulmonary samples positive for CF pathogens in the first year after sinus surgery.