The utility of CT scans in pediatric cystic fibrosis patients with chronic sinusitis

Abstract

Objectives: To evaluate the usefulness of computed tomography scans of the sinuses in children with cystic fibrosis (CF) as an outcomes measurement for chronic sinusitis following medical or surgical intervention. Methods: Consecutive pediatric patients with CF who had sinus scans performed at the study institution from January 1999 to September 2003 were identified. Only patients treated at the study facility pulmonary CF clinic were included. The scans were scored according to the Lund-MacKay system (0 represents no disease and 24 complete sinus opacification). All available prior scans on each patient were also scored. A retrospective chart review determined if hospitalization with intravenous (IV) antibiotic therapy or operative intervention had occurred between scans. Results: A total of 134 patients were identified who met inclusion criteria. Average number of CT scans was 2.4 (range, 1–8). Average Lund scores for the group prior to the first sinus surgery was 14.15 (range, 7–21) and for all additional scans 13.15 (7–24). During the study period average number of hospitalizations was 5.2 (range, 0–21), and average number of sinus operations was 2.2 (range, 0–9) not including second look procedures. There was significant improvement between the preoperative and postoperative Lund score after initial surgery, however, subsequent scans Lund score following either IV antibiotics or surgical interventions were not significantly different. Conclusions: While sinus CT scans serve an invaluable role in preoperative planning, especially in revision surgery, repetitive scanning is not useful in monitoring disease progression and does not correlate with clinical exacerbations or medical or surgical treatments following initial surgery in pediatric CF patients.