Nasal endoscopic and CT scan alterations of the paranasal sinuses as predictors of severity in patients with cystic fibrosis.
Cystic Fibrosis (CF) results from mutation in the transmembrane conductance regulator gene, responsible for controlling secretory processes. The upper airways (UA) are usually involved in the form of chronic pansinusitis.


OBJECTIVE
To evaluate UA changes in patients with CF and to establish the correlations between sinonasal CT and endoscopic endonasal findings and disease severity.


METHODS
Cross-sectional and prospective study with 20 patients older than 5 years with CF, assessing the Shwachman-Kulczycki (S-K) score, paranasal sinus tomography (CT) (Lund-Mackay score) and nasal endoscopy (Meltzer score).


RESULTS
CT scan alterations were observed in 94% of cases. Endoscopic alterations findings in the upper airways were found in 10 patients. Nasal polyps were found in 3 patients (15%). There was a correlation between the intensity of changes on the CT and S-K score (p = 0.0097), and between endoscopic findings and S-K score (p = 0.0318). There was a positive correlation between the presence of chronic colonization and endoscopic findings (p = 0.0325), which was not observed on the CT (p = 0.2941).


CONCLUSIONS
There is an inverse correlation between the S-K clinical score and nasal endoscopy and CT findings. Therefore, patients who are clinically more severe according to the S-K score have greater UA involvement.
Department of Surgery, Medical School of the Federal University of Ceará, Rua Profesor Costa Mendes no. 1608, Rodolfo Teófilo, Fortaleza - CE, Brazil. marcosrabeloufc@gmail.com
Marcos Rabelo de
MR
Freitas
Déborah Nogueira
DN
Vasconcelos
Angela Elizabeth de Holanda Araújo
AE
Freitas
José Holanda
JH
Maia Filho
Claudia de
Cd
Castro e Silva
D000293:Adolescent; D000328:Adult; D002648:Child; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000150:complications*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D009298:Nasal Polyps / Q000209:etiology*; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging* / Q000382:microbiology; D011446:Prospective Studies; D012720:Severity of Illness Index; D012852:Sinusitis / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D055815:Young Adult