The Risks of Complications During Endoscopic Sinus Surgery in Cystic Fibrosis Patients: An Anatomical and Endoscopic Study.
Adolescent
Adult
Anatomic Variation
Case-Control Studies
Chronic Disease
Cystic Fibrosis
/ complications
Endoscopy
/ methods
Female
Humans
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Rhinitis
/ diagnostic imaging
Risk Factors
Sinusitis
/ diagnostic imaging
Tomography, X-Ray Computed
Cystic fibrosis
chronic rhinosinusitis
endoscopic sinus surgery
radiology
sinus anatomy
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
revised:
30
12
2020
received:
23
11
2020
accepted:
05
01
2021
pubmed:
20
1
2021
medline:
21
9
2021
entrez:
19
1
2021
Statut:
ppublish
Résumé
An increasing proportion of adult cystic fibrosis (CF) patients is being referred to endoscopic sinus surgery (ESS) in order to relieve the symptoms of chronic rhinosinusitis (CRS). Given that CFTR mutations profoundly alter sinonasal development, we want to explore the relationship between their peculiar surgical anatomy and the risk of postoperative complications. Retrospective case-control study. Paranasal sinuses CT scans of 103 CF adult patients with CRS were compared to those belonging to a cohort of 100 non-CF adult patients to explore their anatomical differences. Secondly, CF and non-CF patients who received primary/revision ESS were analyzed in order to assess their preoperative CT scan in terms of surgically relevant variants, and according to the CLOSE checklist. Surgical outcomes were statistically compared in order to explore the differences between groups. CF group presented more frequently with smaller and less pneumatized paranasal sinuses and a higher Lund-Mckay score compared with controls. No anatomical differences emerged in terms of genotype stratification. Non-CF CRS patients undergoing ESS showed a significantly deeper olfactory fossa and a more frequent supraorbital pneumatization compared to CF patients (P < .001 and P = .031, respectively). Whereas this latter group underwent more often aggressive surgical procedures (P = .001), no difference in terms of postoperative adverse events was found (P = .620). Despite receiving more often aggressive ESS procedures, adult CF patients do not show an increased risk of postoperative complication and this may be linked to a different proportion of anatomical and surgically-relevant variants. 4 Laryngoscope, 131:E2481-E2489, 2021.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
E2481-E2489Informations de copyright
© 2021 The American Laryngological, Rhinological and Otological Society, Inc.
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