Effects of sinus surgery in patients with cystic fibrosis after lung transplantation: a 10-year experience.
Chronic infectious rhinosinusitis with Pseudomonas aeruginosa is common in cystic fibrosis and may result in allograft infection after lung transplantation. Sinus surgery followed by nasal care may reduce these adverse effects. Sinus surgery was performed in 37 patients with cystic fibrosis after transplantation. Bacteriology of sinus aspirates (n=771) and bronchoalveolar lavage (BAL) (n=256) was correlated with clinical data. Sinus surgery was successful in 54% and partially successful in 27% of patients. A significant correlation between negative sinus aspirates and negative BAL and between positive sinus aspirates and positive BAL (P<0.0001) was found. Successful sinus management led to a lower incidence of tracheobronchitis and pneumonia (P=0.009) and a trend toward a lower incidence of bronchiolitis obliterans syndrome (P=0.23). Sinus surgery followed by daily nasal douching may control posttransplant lower airway colonization and infection. In the long term, this concept may lead to less bronchiolitis obliterans syndrome by decreasing bronchiolar inflammation.
Holzmann
David
D
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Zurich, Switzerland.
Speich
Rudolf
R
Kaufmann
Thomas
T
Laube
Irene
I
Russi
Erich W
EW
Simmen
Daniel
D
Weder
Walter
W
Boehler
Annette
A
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007223:Infant; D007249:Inflammation / Q000453:epidemiology / Q000517:prevention & control; D016040:Lung Transplantation; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000601:surgery*; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000517:prevention & control; D012220:Rhinitis / Q000382:microbiology; D012852:Sinusitis / Q000382:microbiology; D016019:Survival Analysis
D000900:Anti-Bacterial Agents