Evaluation of chronic rhinosinusitis management using the SNOT-22 in adult cystic fibrosis patients

OBJECTIVES: Sinonasal disease (SND) is a common finding in subjects with Cystic Fibrosis (CF). Even though it does not play a key role in the life expectancy of these patients, it increases the morbidity rate of CF, with deterioration of the quality of life and of general health status. The aim of this study is the evaluation of the impact of sinonasal disease and Extensive Endoscopic Sinus Surgery (eESS) on the quality of life (QOL) of CF patients by means of the 22 item Sino-Nasal Outcome Test (SNOT-22) and define if there is a correlation between SNOT-22 and the Lund-Mackay score. PATIENTS AND METHODS: We performed a prospective study in 33 CF patients with medically refractory SND. The extent of polyposis was graded both endoscopically and on computed tomography images in accordance with the Lund-Mackay score. All patients underwent eESS. The SNOT was administered in order to assess the quality of life related to SND both before surgery and during follow-up at 6 months, 1 year and 2 years postoperatively. RESULTS: The SNOT-22 and Lund-Mackay score showed a remarkable mean improvement during follow-up. The differences between the initial examination and last score were significant (p < 0.001), but there was no statistic correlation between SNOT-22 and Lund-Mackay. CONCLUSIONS: More attention should be paid to sinonasal symptoms in CF patients and SNOT-22 is a simple and effective tool for this purpose. This score is also important for indicating the outcome of the eESS procedure. In all patients SNOT showed a significant improvement in QoL.