title: Importance to question sinonasal symptoms and to perform rhinoscopy and rhinomanometry in cystic fibrosis patients.
abstract: Cystic fibrosis (CF) patients almost regularly reveal sinonasal pathology. The purpose of this study was to assess association between objective and subjective measurements of sinonasal involvement comparing nasal airflow obtained by active anterior rhinomanometry (AAR), nasal endoscopic findings, and symptoms assessed with the Sino-Nasal Outcome Test-20 (SNOT-20).
  
  
  
  Nasal cavities were explored by anterior rigid rhinoscopy and findings were compared to inspiratory nasal airflow measured by AAR to quantify nasal patency and subjective health-related quality of life in sinonasal disease obtained with the SNOT-20 questionnaire. Relations to upper and lower airway colonization with Pseudomonas aeruginosa, medical treatment, and sinonasal surgery were analysed.
  
  
  
  A total of 124 CF patients were enrolled (mean age 19.9 ± 10.4 years, range 4-65 years). A significant association of detection of nasal polyposis (NP) in rhinoscopy was found with increased primary nasal symptoms (PNS) which include "nasal obstruction," "sneezing," "runny nose," "thick nasal discharge," and "reduced sense of smell." At the same time patients with pathologically decreased airflow neither showed elevated SNOT-20 scores nor abnormal rhinoscopic findings. Altogether, rhinomanometric and rhinoscopic findings are not significantly related.
  
  
  
  Among SNOT-20 scores the PNS subscore is related to rhinoscopically detected polyposis and sinonasal secretion. Therefore, we recommend including short questions regarding PNS into CF-routine care. At the same time our results show that a high inspiratory airflow is not associated with a good sensation of nasal patency. Altogether, rhinomanometry is not required within routine CF-care, but it can be interesting as an outcome parameter within clinical trials. Pediatr Pulmonol. 2017;52:167-174. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Paediatrics, Cystic Fibrosis Centre, Jena University Hospital, Jena, Germany.
authors.forename: J M
authors.initials: JM
authors.lastname: Bock
authors.affiliation: Surgical and Perioperative Sciences, Umeå University Hospital, Umeå, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Schien
authors.affiliation: Department of Paediatrics, Cystic Fibrosis Centre, Jena University Hospital, Jena, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Fischer
authors.affiliation: Department of Paediatrics, Giessen University Hospital, Giessen, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Naehrlich
authors.affiliation: CF Center, Chemnitz Hospital, Chemnitz, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kaeding
authors.affiliation: Department of Otorhinolaryngology, University Hospital, Jena, Germany.
authors.forename: O
authors.initials: O
authors.lastname: Guntinas-Lichius
authors.affiliation: Department of Paediatrics, Cystic Fibrosis Centre, Jena University Hospital, Jena, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Gerber
authors.affiliation: Department of Paediatrics, Cystic Fibrosis Centre, Jena University Hospital, Jena, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Arnold
authors.affiliation: Department of Paediatrics, Cystic Fibrosis Centre, Jena University Hospital, Jena, Germany.
authors.forename: J G
authors.initials: JG
authors.lastname: Mainz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002353:Carrier State / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000453:epidemiology / Q000503:physiopathology*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D015508:Nasal Obstruction / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D009666:Nose; D000857:Olfaction Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D011552:Pseudomonas Infections / Q000453:epidemiology; D011550:Pseudomonas aeruginosa; D011788:Quality of Life; D025363:Rhinomanometry; D012912:Sneezing; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: cystic fibrosis; nasal patency; rhinoscopy; sinonasal outcome test; upper airways