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Cystic fibrosis exacerbations treated with medical therapy with and without concurrent sinus surgery

Drew H Smith1, Jeffrey J Falco2, Aditya K Devarakonda2

  • 1Department of Otolaryngology - Head and Neck Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA.

International Journal of Pediatric Otorhinolaryngology
|August 6, 2022
PubMed

Insights

Functional endoscopic sinus surgery (FESS) with medical management (MM) did not significantly improve pulmonary function test (PFT) outcomes in pediatric cystic fibrosis (CF) patients compared to MM alone during CF exacerbations.

Area of Science:

  • Pediatric Pulmonology
  • Otolaryngology
  • Cystic Fibrosis Research

Background:

  • Cystic Fibrosis (CF) exacerbations often involve sinonasal complications.
  • Functional endoscopic sinus surgery (FESS) is sometimes used alongside medical management (MM) for CF patients.
  • The impact of FESS on pulmonary function during CF exacerbations requires further investigation.

Purpose of the Study:

  • To compare pulmonary function test (PFT) outcomes in pediatric CF patients receiving FESS with MM versus MM alone for CF exacerbations.
  • To assess the effect of FESS on PFTs at various time points post-treatment.

Main Methods:

  • Prospective cohort study conducted at a pediatric tertiary care facility.
  • Included pediatric patients (age ≤ 18) hospitalized for CF exacerbations.
  • Utilized two-way ANOVA with repeated measures to analyze PFT outcomes (including FEV1) over time (admission, discharge, 3, 6, 12 months) comparing FESS with MM to MM alone.

Main Results:

  • No statistically significant interaction between treatment type (FESS with MM vs. MM alone) and time on PFT outcomes (p=0.492).
  • No significant difference in FEV1 between the two treatment groups (p=0.737).
  • No significant association between treatment type and time to hospital readmission (p=0.111).

Conclusions:

  • FESS combined with MM does not demonstrate a significant benefit over MM alone for improving PFT outcomes in pediatric CF patients during exacerbations.
  • The addition of FESS to MM did not alter pulmonary function or hospital readmission rates within the study timeframe.
Abstract

Keywords:
CFCystic fibrosisFESSFEV1OutcomesPFTsSinus surgeryUnified airway theory

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