Update on the Management of Chronic Rhinosinusitis in Patients with Cystic Fibrosis: A Literature Review

Abstract

Cystic fibrosis is an autosomal recessive genetic disease caused by mutations in the CFTR channel. These mutations determines an alteration in the exchange of chloride and bicar­bonate, leading to thickening of mucus and subsequent mucociliary dysfunction. This re­sults in multisystemic symptoms, with pulmonary manifestations being of primary concern. While sinus symptoms may not manifest universally among individuals with cystic fibrosis, radiological prevalence of 100% is described. Beyond contributing to systemic morbidity, these symptoms serve as a reservoir for bacteria and a source of pulmonary exacerbations. Clinically, it has been observed that these patients are refractory to conventional therapies used for chronic rhinosinusitis. This literature review describes different treatments propo­sed for this population: nasal saline lavage, intranasal corticosteroids, topical antibiotics, CFTR modulators, endoscopic sinus surgery.