The Role of Endoscopic Sinus Surgery in Children with Cystic Fibrosis

Objectives: The aim of this study was to assess the role of functional endoscopic sinus surgery (FESS) in the treatment of chronic rhinosinusitis (CRS) in children with cystic fibrosis (CF). Methods: We performed a comprehensive review of the literature by searching PubMed/MEDLINE. Results: CRS affects most children with CF. Though subjective symptoms are variable, radiological and endoscopic examination demonstrated typical objective findings. FESS is recommended for children with significant nasal symptoms that do not respond to medical treatment. At present, there are no uniform criteria for timing and extension of surgery. Primary surgery includes nasal polypectomy and correction of any bone anatomical variants that reduce ventilation of paranasal sinuses predisposing to recurrent sinusitis and complications. In case of recurrences, revision surgery supports a more expanded surgical approach. Moreover, FESS can relieve symptoms, improve patients' quality of life, manage complications, ameliorate the delivery of medical therapy, and reduce sinonasal and lung superinfections. Conclusions: FESS has emerged as a safe and effective procedure for the treatment of CRS in children with CF. Since children with CF and CRS are difficult-to-treat patients, a multidisciplinary approach in tertiary-care referral centers is required.