FESS Does Not Improve Lung Function in Cystic Fibrosis

Abstract

Objective: Functional endoscopic sinus surgery (FESS) provides symptomatic relief of sinus disease in patients with CF (cystic fibrosis), but it is unclear whether it has beneficial effects on lung disease in this population. This study assessed the effect of FESS on the respiratory status of adult CF patients.

Method: We performed a retrospective chart review at a tertiary medical center encompassing 32 adult CF patients who underwent 45 operative cases. Outcome measures were the effect of FESS on the rate of decline in lung function, intravenous antibiotic use, and hospitalization for pulmonary exacerbation.

Results: FESS was performed in 32 patients encompassing maxillary antrostomy, ethmoidectomy, frontal sinusotomy, sphenoidectomy, and polypectomy. The rate of decline in FEV1 and FVC were not significantly different in the 12 months before and after FESS. FESS did not reduce days hospitalized or days on intravenous antibiotics for a respiratory exacerbation in the pre- vs postoperative period. Limiting the analysis to the 30 surgeries that were performed in patients with concomitant respiratory symptoms did not significantly alter the results. Covariates of importance in CF, including CFTR genotype, gender, or microbiology, did not affect the study results.

Conclusion: FESS does not improve pulmonary status of adults with cystic fibrosis. These results suggest the routine use of FESS to address lung disease progression in CF patients may not be warranted.