Nasal Polyps in Cystic Fibrosis

Abstract

Nasal polyps are common in cystic fibrosis (CF). Nasal polyps in children should prompt appropriate investigations for the potential diagnosis of CF. Possible etiologies for nasal polyp formation in CF include direct consequence of ΔF508 affecting chromosome 7, colonization with microorganisms including Pseudomonas aeroginosa and fungi, and IgE-mediated inflammation. Neutrophils are more common in polyps from CF patients compared with non-CF nasal polyposis. Conservative management with nasal irrigations and nasal steroids constitute first-line treatment. Surgical management of persistent and symptomatic polyps may also improve lung function, and consequently, quality of life. Simple polypectomy has a high rate of early recurrence, and thus, surgery should include at a minimum uncinectomy, middle meatal antrostomy, and anterior ethmoidectomy. Topical delivery of novel medications may reduce the need for surgery.