2018 CSO General Scientific Program

“Management of chronic rhinosinusitis in cystic fibrosis with immediate or deferred surgery”

Noel Ayoub, Andrew Thamboo, Al-Rahim Habib, Peter Hwang

Abstract

Objectives: To compare outcomes of medical versus surgical management of recalcitrant chronic rhinosinusitis (CRS) in cystic fibrosis (CF) patients and the transition between them.

Methods: 136 patients were divided into: medical management (A), upfront surgery(B), or crossover(C). Sino-nasal outcomes (SNOT-22), pulmonary function tests (PFTs), and rates of additional surgeries were assessed up to 48 months.

Results: Greater incidence of nasal polyposis (p=0.0011), prior sinus surgery (p=0.0025), lower %FEV1 (p=0.0063), higher Lund-Mackay (p=0.0025) and SNOT-22 scores (p=0.0229) observed in B (n=46) versus A (N=90). Crossover (n=32) was associated with a 6.1-point increase in SNOT-22 and 6.6% deterioration in %FEV1. Group-C ultimately achieved similar postoperative SNOT-22 (p=0.831) and %FEV1 (p=0.114) as group A. None improved the PFT.

Conclusions: Surgery effectively reduces CRS-related symptoms. A worsening of symptoms may prompt conversion to surgery in group-A. Patients who delay surgery may achieve similar outcomes as those who pursue surgery upfront.

Learning Objectives

  1. To determine whether patients who choose to delay surgery to first receive medical treatment achieve similar outcomes as those who pursue surgery upfront
  2. To discover the patient characteristics associated with the decision to convert from medical to surgical therapy

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Scheduling Details

This 7 minute presentation is scheduled to take place on June 4, 2019 at 15:28 in the Salon 8.

Authors' Contact Details

Corresponding Author: Dr. Andrew Thamboo

Senior Author: Dr. Andrew Thamboo

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