Nasal endoscopic and CT scan alterations of the paranasal sinuses as predictors of severity in patients with cystic fibrosis.

UNLABELLED: Cystic Fibrosis (CF) results from mutation in the transmembrane conductance regulator gene, responsible for controlling secretory processes. The upper airways (UA) are usually involved in the form of chronic pansinusitis. OBJECTIVE: To evaluate UA changes in patients with CF and to establish the correlations between sinonasal CT and endoscopic endonasal findings and disease severity. METHOD: Cross-sectional and prospective study with 20 patients older than 5 years with CF, assessing the Shwachman-Kulczycki (S-K) score, paranasal sinus tomography (CT) (Lund-Mackay score) and nasal endoscopy (Meltzer score). RESULTS: CT scan alterations were observed in 94% of cases. Endoscopic alterations findings in the upper airways were found in 10 patients. Nasal polyps were found in 3 patients (15%). There was a correlation between the intensity of changes on the CT and S-K score (p = 0.0097), and between endoscopic findings and S-K score (p = 0.0318). There was a positive correlation between the presence of chronic colonization and endoscopic findings (p = 0.0325), which was not observed on the CT (p = 0.2941). CONCLUSION: There is an inverse correlation between the S-K clinical score and nasal endoscopy and CT findings. Therefore, patients who are clinically more severe according to the S-K score have greater UA involvement.

As alterações nasofibroscópicas e tomográficas de seios paranasais são preditoras de gravidade em pacientes com fibrose cística / Nasal endoscopic and CT scan alterations of the paranasal sinuses as predictors of severity in patients with cystic fibrosis

A fibrose cística (FC) resulta de mutação no gene regulador da condutância transmembrana, responsável pelo controle dos processos secretores. As vias aéreas superiores (VAS) geralmente são comprometidas na forma de pansinusite crônica. OBJETIVO: Avaliar as alterações das VAS nos pacientes com FC e determinar a correlação entre os achados tomográficos e endoscópicos nasossinusais e a gravidade da doença. MÉTODO: Estudo transversal, prospectivo com 20 pacientes maiores de 5 anos com diagnóstico de FC avaliando escore de Shwachman-Kulczycki (S-K), tomografia de seios paranasais (TC) (escore de Lund-Mackay) e videonasofibroscopia (escore de Meltzer). RESULTADOS: Alterações tomográficas foram observadas em 94% dos casos. Alterações endoscópicas nas VAS foram encontradas em dez pacientes. Pólipo nasal ocorreu em três pacientes (15%). Observou-se correlação entre a intensidade das alterações da TC e o escore S-K (p = 0,0097) e entre os achados endoscópicos e o escore S-K (p = 0,0318). Observou-se relação positiva entre a presença de colonização crônica e os achados endoscópicos (p = 0,0325), o que não foi observado com os achados tomográficos (p = 0,2941). CONCLUSÃO: Há correlação inversa entre o escore clínico de S-K e os achados de TC e nasofibroscopia. Portanto, os pacientes clinicamente mais graves de acordo com o escore de S-K apresentam maior comprometimento de VAS.

Cystic Fibrosis (CF) results from mutation in the transmembrane conductance regulator gene, responsible for controlling secretory processes. The upper airways (UA) are usually involved in the form of chronic pansinusitis. OBJECTIVE: To evaluate UA changes in patients with CF and to establish the correlations between sinonasal CT and endoscopic endonasal findings and disease severity. METHOD: Cross-sectional and prospective study with 20 patients older than 5 years with CF, assessing the Shwachman-Kulczycki (S-K) score, paranasal sinus tomography (CT) (Lund-Mackay score) and nasal endoscopy (Meltzer score). RESULTS: CT scan alterations were observed in 94% of cases. Endoscopic alterations findings in the upper airways were found in 10 patients. Nasal polyps were found in 3 patients (15%). There was a correlation between the intensity of changes on the CT and S-K score (p = 0.0097), and between endoscopic findings and S-K score (p = 0.0318). There was a positive correlation between the presence of chronic colonization and endoscopic findings (p = 0.0325), which was not observed on the CT (p = 0.2941). CONCLUSION: There is an inverse correlation between the S-K clinical score and nasal endoscopy and CT findings. Therefore, patients who are clinically more severe according to the S-K score have greater UA involvement.