Sinus surgery can improve quality of life, lung infections, and lung function in patients with primary ciliary dyskinesia. Issue 3 (23rd November 2016)

• Record Type: Journal Article
• Authors: Alanin, Mikkel Christian; Aanaes, Kasper; Høiby, Niels; Pressler, Tania; Skov, Marianne; Nielsen, Kim Gjerum; Johansen, Helle Krogh; von Buchwald, Christian
• Is Part Of: International forum of allergy & rhinology. Volume 7:Issue 3(2017:Mar.)
• Page Start: 240
• Page End: 247
• Publication Date: 2016-11-23
• Subjects: bacteriology -- chronic rhinosinusitis -- FESS -- computer assisted surgery -- sinusitis; 617.51005
• DOI: 10.1002/alr.21873
• Languages: English
• ISSNs: 2042-6976

Abstract

Abstract : Background: Chronic rhinosinusitis (CRS) and bacterial sinusitis are ubiquitous in patients with primary ciliary dyskinesia (PCD). From the sinuses, Pseudomonas aeruginosa can infect the lungs. Methods: We studied the effect of endoscopic sinus surgery (ESS) on symptoms of CRS and lower airway infections in PCD patients in a prospective single‐arm intervention study of ESS with adjuvant therapy using nasal irrigation with saline, topical nasal steroids, and 2 weeks of systemic antibiotics. Additional treatment with local colistin for 6 months was instigated when P. aeruginosa was cultured at ESS. Results: Twenty‐four PCD patients underwent ESS to search for an infectious focus (n = 10), due to severe symptoms of CRS (n = 8), or both (n = 6). Bacteria were cultured from sinus samples in 21 patients (88%), and simultaneous sinus and lung colonization with identical pathogens were observed in 13 patients (62%). Four patients with preoperative P. aeruginosa lung colonization (25%) had no regrowth during follow‐up; 2 of these had P. aeruginosa sinusitis. Sinonasal symptoms were improved 12 months after ESS and we observed a trend toward better lung function after ESS. Conclusion: We demonstrated an improvement in CRS‐related symptoms after ESS and adjuvant therapy. In selected PCD patients, the suggested regimen may postpone chronic lung infection with P. aeruginosa and stabilize lung function.