Endoscopic sinus surgery in cystic fibrosis: do patients benefit from surgery?

Objective: To examine the effects of endoscopic sinus surgery on the pulmon ary status of cystic fibrosis (CF) patients through the objective parameter s of steroid use, pulmonary function tests (PFTs), and inpatient hospital d ays (IHDs). Methods: Retrospective chart review of all patients with CF who underwent endoscopic sinus surgery from 1993 to 1999 at a tertiary care ch ildren's hospital. Preoperative pulmonary function, inhaler and steroid use , and IHDs were compared to postoperative parameters within a 1-year period . Results: Sixty-six patients, including eight lung transplant patients, un derwent a total of 112 endoscopic sinus surgery procedures; 25 patients und erwent more than one procedure. Patients were taking oral steroids preopera tively in 28% of procedures and inhaled steroids in 40%. Postoperatively, t here was no statistically significant change in oral or inhaled steroid use , or in postoperative pulmonary function. If the index hospitalization, whi ch was often for reasons not related to sinus disease, was considered part of the preoperative time period, endoscopic sinus surgery (ESS) was noted t o result in a marked reduction (9.5 days (adjusted), P=0.001) in hospital d ays during the subsequent 6 months. If the date of the procedure alone was used to define pre- and postoperative time periods, the reduction in postop erative days was more modest and not statistically significant (3.5 days (a djusted), P=0.21). Conclusions: Although we found no statistically signific ant difference in PFTs, or steroid requirements following ESS, ESS may have resulted in a reduced need for hospitalization in the 6 months following t he procedure. Future prospective studies in a larger number of patients and using more detailed outcome measures are needed to better evaluate the eff ects of endoscopic sinus surgery in pediatric patients with CF. (C) 2001 El sevier Science Ireland Ltd. All rights reserved.