Prevalence, variability, and predictors of sinus surgery in pediatric patients with cystic fibrosis

2021 ◽  
Author(s):  
Frank W. Virgin ◽  
Cary Thurm ◽  
Don B. Sanders ◽  
Alvin J. Freeman ◽  
Jonathan Cogen ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pediatric Patients ◽  
Sinus Surgery

The “Hummer”: New Instrumentation for Functional Endoscopic Sinus Surgery

1994 ◽  
Vol 8 (6) ◽  
pp. 275-280 ◽  
Author(s):  
Reuben C. Setliff ◽  
David S. Parsons
Keyword(s):  
Cystic Fibrosis ◽  
Blood Loss ◽  
Pediatric Patients ◽  
Middle Turbinate ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Operative Morbidity ◽  
Mucous Membranes ◽  
New Instrumentation ◽  
Continuous Suction

The “Hummer” microdebrider is a powered rotary shaving device with continuous suction. Its use in functional endoscopic sinus (FES) surgery allows precise and delicate removal of diseased tissue. Traditional FES instruments frequently cause trauma to non-diseased mucosa or inadvertently strip mucous membranes, both of which are counter to the functional concepts. The “Hummer” facilitates preservation of mucosa and vital structures, such as the middle turbinate, by resecting diseased, obstructive tissue with very limited blood loss. Simultaneous continuous suction at the operative site is a marked benefit of this instrument, which helps overcome the well-recognized problem of blood pooling that increases the potential for operative morbidity. Polypectomies are performed in a more precise manner with very little blood loss so that visibility is usually unimpaired, even in patients with cystic fibrosis. The instrument is applicable to most FES cases and is the authors’ preferred technique, even for small pediatric patients. Accelerated healing and reduced synechiae were observed in these patients.

scholarly journals Comprehensive quality of life outcomes for pediatric patients undergoing endoscopic sinus surgery

2014 ◽  
Vol 52 (4) ◽  
pp. 327-333
Author(s):  
Robert J. Taylor ◽  
Justin D. Miller ◽  
Austin S. Rose ◽  
Amelia F. Drake ◽  
Carlton J. Zdanski ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cystic Fibrosis ◽  
Endoscopic Sinus Surgery ◽  
Pediatric Patients ◽  
Clinical Decision Making ◽  
Sinus Surgery ◽  
Nasal Endoscopy ◽  
Change Scores ◽  
General Quality

Background: Limited quality of life data exist for pediatric chronic rhinosinusitis (CRS) patients undergoing endoscopic sinus surgery (ESS). Further exploration of the following areas will enhance understanding and support clinical decision-making: baseline and post-ESS general and disease-specific quality of life, parent vs. child report, and correlation of nasal endoscopy to sinus CT scores. Methodology: A prospective cohort study evaluated CRS patients age 5-18 undergoing ESS. Surveys were completed at two timepoints: (1) pre-ESS and (2) 30-90 days post-ESS, with parents completing general (PedsQLTM) and CRS-specific (SNOT-16 and SN-5) quality of life surveys and children completing PedsQLTM and SNOT-16 surveys. Preoperative Lund-Kennedy nasal endoscopy and Lund-Mackay sinus CT scores were calculated. Where appropriate, outcomes were stratified by cystic fibrosis status. Results: Impaired preoperative general quality of life was evidenced by parent proxy-report of PedsQLTM scores in 10 cystic fibrosis and 11 non-CF patients. ESS was associated with decreased sinus symptoms at 1-3 months postoperatively with SN-5 change scores of -1.85 and -2.2, in CF and non-CF patients, respectively. Parents reported worse CRS symptoms via higher preoperative SNOT-16 scores than their children did. Nasal endoscopy and sinus CT scores correlated with a Spearman correlation coefficient of 0.51. Scores not reaching statistical significance included CF-related CRS SNOT-16 change scores and PedsQLTM general quality of life change scores. Conclusion: In pediatric patients with CRS electing ESS, general quality of life is impaired preoperatively and sinus symptoms improve significantly 1-3 months after sinus surgery. Parents report statistically worse CRS symptom scores than their children do. Nasal endoscopy scores in this cohort correlated with sinus CT scores.

Rhinosinusitis in the Pediatric Patient with Cystic Fibrosis

2014 ◽  
Vol 10 (3) ◽  
pp. 198-201 ◽  
Author(s):  
Christopher Fundakowski ◽  
Rosemary Ojo ◽  
Ramzi Younis
Keyword(s):  
Cystic Fibrosis ◽  
Autosomal Recessive ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Chronic Sinusitis ◽  
Genetic Disorder ◽  
Symptomatic Relief ◽  
Recurrence Rates ◽  
Polyp Recurrence ◽  
Sinonasal Polyposis

Cystic fibrosis (CF) is a common autosomal recessive genetic disorder where a deletion mutation and subsequent downstream alteration in transmembrane regulator proteins results in increased mucus viscosity. CF manifests clinically with chronic multisystem inflammation and recurrent infections. Nearly all children with CF have chronic sinusitis, and a large majority will have concurrent sinonasal polyposis. Chronic sinusitis and sinonasal polyposis in pediatric patients with CF can be managed conservatively initially, though most will fail medical management and require surgical intervention. Unfortunately, symptom resolution is marginal and polyp recurrence rates are high. Currently, no cure exists for CF and the mainstay of treatment is to provide symptomatic relief, and minimize disease morbidity.

Population Pharmacokinetics of Tobramycin Inhalation Solution in Pediatric Patients With Cystic Fibrosis

2017 ◽  
Vol 106 (11) ◽  
pp. 3402-3409 ◽  
Author(s):  
Xinting Wang ◽  
Stephan Koehne-Voss ◽  
SivaNaga S. Anumolu ◽  
Jing Yu
Keyword(s):  
Cystic Fibrosis ◽  
Population Pharmacokinetics ◽  
Pediatric Patients

Nutrition Management of Pediatric Patients Who Have Cystic Fibrosis

2009 ◽  
Vol 56 (5) ◽  
pp. 1123-1141 ◽  
Author(s):  
Suzanne H. Michel ◽  
Asim Maqbool ◽  
Maria D. Hanna ◽  
Maria Mascarenhas
Keyword(s):  
Cystic Fibrosis ◽  
Pediatric Patients ◽  
Nutrition Management

Increased Plasma YKL-40 Level and Chitotriosidase Activity in Cystic Fibrosis Patients

2021 ◽  
Author(s):  
Dilara Bal Topcu ◽  
Gökcen Tugcu ◽  
Berrin Er ◽  
Sanem Eryilmaz Polat ◽  
Mina Hizal ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pediatric Patients ◽  
Adult Patients ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Children ◽  
Plasma Samples ◽  
Stable Period ◽  
Valuable Marker ◽  
Chitotriosidase Activity ◽  
Relevant Factors

Abstract Background We investigated plasma YKL-40 levels and chitotriosidase (CHIT1) activity in patients with cystic fibrosis (CF) lung disease and evaluated clinically relevant factors that may affect their levels. Methods Plasma samples were obtained from pediatric (n = 19) and adult patients (n = 15) during exacerbation, discharge and stable period of the disease. YKL-40 levels and chitotriosidase activity were measured by enzyme-linked immunosorbent assay and fluorometric assay, respectively. Data were compared with healthy children and adults of similar age. Results YKL-40 levels of pediatric and adult CF patients at all periods were significantly higher than controls (p < 0.001 and p < 0.05). CHIT1 activities of adult patients at all periods were significantly higher compared to controls (p < 0.05). On the other hand, CHIT1 activities of pediatric CF patients were similar with controls. YKL-40 levels of exacerbation period of adult CF patients were negatively correlated with % FVC (r= -0.800, p = 0.014) and % FEV1 (r= -0.735, p = 0.008). YKL-40 levels in the exacerbation period of pediatric CF patients were negatively correlated with % FVC (r= -0.697, p = 0.0082) and % FEV1 (r= -0.720, p = 0.006). Conclusions CHIT1 activity may be a valuable marker of chronic inflammation in adult CF patients who suffer from CF for a longer period of time compared to pediatric patients. Increased YKL-40 levels in both pediatric and adult patients compared to controls may point to a role in between CF pathology. Furthermore, as YKL-40 levels are correlated with FEV1 and FVC in patients, it may be useful for the monitoring of pulmonary function in CF patient.

Outcomes of sinus surgery in adults with cystic fibrosis

2009 ◽  
Vol 141 (3) ◽  
pp. P115-P115 ◽  
Author(s):  
Ayesha N. Khalid ◽  
Timothy Smith ◽  
Jess Collin Mace
Keyword(s):  
Cystic Fibrosis ◽  
Sinus Surgery

Perioperative Strategies to Improve Sinus Surgery Outcomes in Patients with Cystic Fibrosis

2013 ◽  
Vol 149 (1) ◽  
pp. 30-39 ◽  
Author(s):  
David J. Crockett ◽  
Kevin F. Wilson ◽  
Jeremy D. Meier
Keyword(s):  
Cystic Fibrosis ◽  
Sinus Surgery ◽  
Surgery Outcomes

scholarly journals Chronic rhinosinusitis in adult patients with cystic fibrosis: clinical manifestation and therapeutic approaches

2019 ◽  
Vol 29 (3) ◽  
pp. 311-320
Author(s):  
G. L. Shumkova ◽  
E. L. Amelina ◽  
V. M. Svistushkin ◽  
E. V. Sin’kov ◽  
S. A. Krasovskiy ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Adult Patients ◽  
Sinus Surgery ◽  
Markers Of Inflammation

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. 

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