title: CT-abnormalities, bacteriology and symptoms of sinonasal disease in children with Cystic Fibrosis.
abstract: Sinonasal pathology in adults with Cystic Fibrosis (CF) is common but the extent of CT-abnormalities and symptoms of sinonasal disease in children with CF and the age of onset are less frequently studied.
  
  
  
  In this observational, cross-sectional study 58 children with CF from two CF centres were included. All subjects completed a questionnaire regarding sinonasal symptoms, underwent a CT scan of the paranasal sinuses, and in each subject a culture of the upper airways was performed. Subjects were divided in 6 age cohorts (0-2, 3-5, 6-8, 9-11, 12-14 and 15-17years) and were divided into severe and mild CF based on their CFTR mutation. Opacification of the sinonasal system of the subjects was compared with opacification on MRI-scans of an age-matched control group without CF.
  
  
  
  Most frequently reported symptoms were nasal obstruction and posterior/anterior nasal discharge. Opacification was abundant in every age cohort of the study group and was significantly more compared to the control group. In patients with severe CF the opacification was higher than subjects with mild CF. Upper airway cultures showed predominantly Staphylococcus aureus, Haemophilus influenzae and Pseudomonas aeruginosa.
  
  
  
  CT-abnormalities indicating sinonasal disease and symptoms are present from shortly after birth which may argue for a thorough examination of the upper airways in children with CF.
authors.affiliation: Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: M C
authors.initials: MC
authors.lastname: Berkhout
authors.affiliation: Department of Radiology, Haga Teaching Hospital, The Hague, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Klerx-Melis
authors.affiliation: Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: W J
authors.initials: WJ
authors.lastname: Fokkens
authors.affiliation: Department of Paediatrics, Haga Teaching Hospital, The Hague, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Nuijsink
authors.affiliation: Department of Paediatric Respiratory Diseases, Emma Children's Hospital AMC, Amsterdam, The Netherlands.
authors.forename: W M C
authors.initials: WM
authors.lastname: van Aalderen
authors.affiliation: Department of Pulmonology, Haga Teaching Hospital, The Hague, The Netherlands.
authors.forename: H G M
authors.initials: HG
authors.lastname: Heijerman
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology; D019005:Cystic Fibrosis Transmembrane Conductance Regulator / Q000235:genetics; D005260:Female; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009154:Mutation; D015508:Nasal Obstruction / Q000175:diagnosis / Q000209:etiology; D009426:Netherlands / Q000453:epidemiology; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013223:Statistics as Topic; D063189:Symptom Assessment / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019005:Cystic Fibrosis Transmembrane Conductance Regulator
keywords: CT scan; Children; Cystic Fibrosis; Genotype; Microbiology; Rhinosinusitis