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CT-abnormalities, bacteriology and symptoms of sinonasal disease in children with Cystic Fibrosis
M C Berkhout1, F Klerx-Melis2, W J Fokkens1
1Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands.
Insights
Sinonasal abnormalities and symptoms are common in children with Cystic Fibrosis (CF), appearing early in life. Early examination of the upper airways is recommended for pediatric CF patients.
Area of Science:
- Pediatric Otolaryngology
- Respiratory Medicine
- Medical Imaging
Background:
- Sinonasal pathology is prevalent in adults with Cystic Fibrosis (CF).
- The extent of CT-abnormalities and sinonasal symptoms in pediatric CF patients, including age of onset, are less understood.
- Understanding sinonasal disease in children with CF is crucial for early intervention.
Purpose of the Study:
- To investigate the prevalence and characteristics of sinonasal abnormalities and symptoms in children with Cystic Fibrosis.
- To determine the age of onset for sinonasal disease in pediatric CF patients.
- To compare sinonasal opacification in children with CF to a healthy control group.
Main Methods:
- An observational, cross-sectional study included 58 children with CF from two centers.
- Participants completed sinonasal symptom questionnaires and underwent paranasal sinus CT scans.
- Upper airway cultures were performed, and CT findings were compared to age-matched MRI controls.
Main Results:
- Nasal obstruction and discharge were the most common symptoms reported.
- Significant sinonasal opacification was observed in all pediatric CF age cohorts compared to controls.
- Severe CF patients exhibited greater opacification than mild CF patients; common pathogens included S. aureus, H. influenzae, and P. aeruginosa.
Conclusions:
- CT-abnormalities and sinonasal symptoms are present from early childhood in patients with Cystic Fibrosis.
- These findings support the need for thorough upper airway examinations in children diagnosed with CF.
- Early detection and management of sinonasal disease in pediatric CF are essential.
Background:
Sinonasal pathology in adults with Cystic Fibrosis (CF) is common but the extent of CT-abnormalities and symptoms of sinonasal disease in children with CF and the age of onset are less frequently studied.
Methods:
In this observational, cross-sectional study 58 children with CF from two CF centres were included. All subjects completed a questionnaire regarding sinonasal symptoms, underwent a CT scan of the paranasal sinuses, and in each subject a culture of the upper airways was performed. Subjects were divided in 6 age cohorts (0-2, 3-5, 6-8, 9-11, 12-14 and 15-17years) and were divided into severe and mild CF based on their CFTR mutation. Opacification of the sinonasal system of the subjects was compared with opacification on MRI-scans of an age-matched control group without CF.
Results:
Most frequently reported symptoms were nasal obstruction and posterior/anterior nasal discharge. Opacification was abundant in every age cohort of the study group and was significantly more compared to the control group. In patients with severe CF the opacification was higher than subjects with mild CF. Upper airway cultures showed predominantly Staphylococcus aureus, Haemophilus influenzae and Pseudomonas aeruginosa.
Conclusion:
CT-abnormalities indicating sinonasal disease and symptoms are present from shortly after birth which may argue for a thorough examination of the upper airways in children with CF.
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