Update on long-term outcomes for chronic rhinosinusitis in cystic fibrosis

Curr Opin Otolaryngol Head Neck Surg. 2020 Feb;28(1):46-51. doi: 10.1097/MOO.0000000000000596.

Abstract

Purpose of review: This article reviews the existing body of literature regarding long-term outcomes of various treatments for chronic rhinosinusitis (CRS) in the cystic fibrosis population.

Recent findings: The management of CRS in cystic fibrosis involves a multitude of medical and surgical therapies. Despite their high usage amongst clinicians, corticosteroids and antibiotics currently have little outcome data supporting their use. There is emerging evidence demonstrating beneficial outcomes for DNAse mucolytics and molecular modulators of cystic fibrosis transmembrane conductor regulator (CFTR). Endoscopic sinus surgery (ESS) improves sinonasal outcomes in cystic fibrosis CRS; however, the benefit on pulmonary outcomes remains unclear.

Summary: Successful management of CRS in cystic fibrosis requires multimodal and multidisciplinary care. The long-term outcome data is variable for different treatment modalities. There is recent evidence supporting the role of DNAse mucolytics, CFTR-targeting therapies, and ESS in management of cystic fibrosis CRS.

Publication types

  • Review

MeSH terms

  • Chloride Channel Agonists / therapeutic use
  • Chronic Disease
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis Transmembrane Conductance Regulator
  • Deoxyribonucleases / therapeutic use
  • Endoscopy
  • Expectorants / therapeutic use
  • Humans
  • Rhinitis / etiology
  • Rhinitis / therapy*
  • Sinusitis / etiology
  • Sinusitis / therapy*
  • Treatment Outcome

Substances

  • Chloride Channel Agonists
  • Expectorants
  • Cystic Fibrosis Transmembrane Conductance Regulator
  • Deoxyribonucleases