Nasally inhaled dornase alfa in the postoperative management of chronic sinusitis due to cystic fibrosis

Objective: To determine the benefit of nasally inhaled dornase alia in cyst ic fibrosis (CF) sinusitis. Design: Retrospective chart review comparing postsurgical course, radiograp hic studies, and pulmonary function test results in patients who were treat ed with nasally inhaled dornase alfa with those in patients who were not tr eated with dornase alfa. Patients: Twenty consecutive patients with CF who underwent functional endo scopic sinus surgery from 1993 to 1997 were included in the study. Treatmen t with nasally inhaled dornase alfa was initiated in 5 of the 20 patients a fter they underwent functional endoscopic sinus surgery. Setting: Tertiary care academic center. Results: The dornase alfa-treated patients had less mucosal edema and no po lyps at serial endoscopy over 3 years compared with the non-dornase alfa-tr eated patients. The patients who received nasally inhaled dornase alfa also underwent fewer revision functional endoscopic sinus surgical procedures ( 1.6 vs 3.2), even though there was essentially no change in pulmonary funct ion test results in these patients. Conclusions: Sinusitis continues to be a major cause of morbidity in patien ts with CF. Symptomatic patients frequently require multiple drug regimens, including longterm systemic antibiotic therapy, topical and systemic stero id therapy, and antibiotic nasal irrigations. This preliminary study indica tes the potential impact of nasally inhaled dornase alfa in controlling pos toperative symptoms in CF sinusitis.