Cystic Fibrosis and Nasal Polyposis

Ford D. Albritton IV, MD, and Todd T. Kingdom, MD, Emory University, Atlanta, Ga.

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Abstract

Nasal polyposis is a sinonasal manifestation of cystic fibrosis (CF)--an autosomal recessive exocrinopathy. Up to 67% of all CF patients will manifest polyps in their lifetime. Symptoms include nasal airway obstruction, anosmia, rhinorrhea, and exacerbation of the rhinosinusitis that affects these patients. The polyps are probably a consequence of chronic inflammation; however, their specific etiology is unclear. Treatment includes antibiotics, topical nasal steroids, decongestants, and mucolytics. Surgery is necessary when conservative measures fail. Endoscopic sinus surgery (ESS) has replaced traditional treatments such as intranasal polypectomy and Caldwell-Luc procedure. ESS combined with medical therapy has successfully delayed the time to recurrence, decreased the need for surgery, and improved the underlying pulmonary status in several studied patient groups. This article reviews typical patient symptoms, physical examination, the use of computed tomography (CT), nasal endoscopic findings, patient prognosis, and the latest research and innovations.

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