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Modified Lothrop procedure in cystic fibrosis patients: does it have a role?

Published online by Cambridge University Press:  11 June 2013

M-C Jaberoo ,
M-A Pulido  and
H A Saleh
M-C Jaberoo*
Affiliation:
Department of Otorhinolaryngology, Charing Cross Hospital, London, UK
M-A Pulido
Affiliation:
Department of Otorhinolaryngology, Charing Cross Hospital, London, UK
H A Saleh
Affiliation:
Department of Otorhinolaryngology, Charing Cross and Royal Brompton Hospitals, Imperial College London, UK
*
Address for correspondence: Miss M-C Jaberoo, Department of Otorhinolaryngology, Northwick Park Hospital, Middlesex HA1 3UJ, UK Fax: 0208 8692964 E-mail: [email protected]
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Abstract

Background:

The management of frontal sinus disease in cystic fibrosis patients represents a challenge for many surgeons. Procedures can vary from the minimally invasive to those involving extensive open surgery.

Objective:

This study describes the outcomes of the endoscopic modified Lothrop procedure, in terms of safety and morbidity, for cystic fibrosis patients with frontal sinus disease who did not improve following traditional functional endoscopic sinus surgery.

Method and results:

The study setting was a tertiary referral unit in a London teaching hospital, the largest national base for adult cystic fibrosis patients. Two patients diagnosed in childhood with cystic fibrosis presented with histories of recurrent, severe frontal sinusitis; both had previously undergone multiple endoscopic sinus surgical procedures. The modified Lothrop procedure was performed on both patients. The outcome measures were symptom resolution and post-operative complications.

Conclusion:

The endoscopic modified Lothrop procedure was beneficial in the cystic fibrosis patients with frontal sinus disease who failed to respond to standard functional endoscopic sinus surgery procedures.

Keywords

Cystic FibrosisFrontal SinusSinusitisSurgical ProceduresOperative
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 7 , July 2013 , pp. 666 - 669
Copyright
Copyright © JLO (1984) Limited 2013 

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Footnotes

Presented as a poster at the British Rhinological Society Meeting, 23 May 2008, Liverpool, UK.

References

1Gysin, C, Alothman, GA, Papsin, BC. Sinonasal disease in cystic fibrosis: clinical characteristics, diagnosis and management. Pediatr Pulmonol 2000;30:481–93.0.CO;2-N>CrossRefGoogle ScholarPubMed
2Eggesbø, HB, Søvik, S, Dølvik, S, Eiklid, E, Kolmannskog, F. CT characterization of developmental variations of the paranasal sinuses in cystic fibrosis. Acta Radiol 2001;42:482–93CrossRefGoogle ScholarPubMed
3Mainz, JG, Koitschev, A. Management of chronic rhinosinusitis in CF. J Cyst Fibros 2009;8(suppl 1):S10–4CrossRefGoogle ScholarPubMed
4Cystic Fibrosis Foundation. Patient Registry 2004. Annual Data Report. Bethesda, Maryland: Cystic Fibrosis Foundation, 2005Google Scholar
5Loebinger, MR, Bilton, D, Wilson, R. Upper airway 2: bronchiectasis, cystic fibrosis and sinusitis. Thorax 2009;64:1096–101CrossRefGoogle ScholarPubMed
6Schulte, DL, Kasperbauer, JL. Safety of paranasal sinus surgery in patients with cystic fibrosis. Laryngoscope 1998;108:1813–5CrossRefGoogle ScholarPubMed
7Rowe-Jones, JM, Mackay, IS. Endoscopic sinus surgery in the treatment of cystic fibrosis with nasal polyposis. Laryngoscope 1996;106:1540–4CrossRefGoogle ScholarPubMed
8Lothrop, HA. Frontal sinus suppuration. Ann Surg 1914;59:937–57CrossRefGoogle ScholarPubMed
9May, M. Frontal sinus surgery: endonasal, endoscopic osteoplasty rather than external osteoplasty. Oper Tech Otolaryngol Head Neck Surg 1991;2:226–31CrossRefGoogle Scholar
10Gross, CW, Zachmann, GC, Becjer, DG, Vickery, CL, Moore, DF, Lindsey, WH et al. Follow-up of University of Virginia experience with the modified Lothrop procedure. Am J Rhinol 1997;11:49–54CrossRefGoogle ScholarPubMed
11Rickert, S, Banuchi, VE, Germana, JD, April, MM. Cystic fibrosis and endoscopic sinus surgery. Arch Otolaryngol Head Neck Surg 2010;136:988–92CrossRefGoogle ScholarPubMed
12Bresciani, M, Paradis, L, Des Roches, A, Vernhet, H, Vachier, I, Godard, P et al. Rhinosinusitis in severe asthma. J Allergy Clin Immunol 2001;107:73–80CrossRefGoogle ScholarPubMed
13Ragab, S, Scadding, GK, Lund, VJ, Saleh, H. Treatment of chronic rhinosinusitis and its effects on asthma. Eur Respir J 2006;28:68–74CrossRefGoogle ScholarPubMed
14Taylor, RF, Morgan, DW, Nicholson, PS, Mackay, IS, Hodson, ME, Pitt, TL. Extrapulmonary sites of Pseudomonas aeruginosa in adults with cystic fibrosis. Thorax 1992;47:426–8CrossRefGoogle ScholarPubMed
15Davidson, TM, Murphy, C, Mitchell, M, Smith, C, Light, M. Management of chronic sinusitis in cystic fibrosis. Laryngoscope 1995;105:354–8CrossRefGoogle ScholarPubMed
16Walter, S, Gudowius, P, Bosshammer, J, Römling, U, Weissbrodt, H, Schürmann, W et al. Epidemiology of chronic Pseudomonas aeruginosa infections in the airways of lung transplant recipients with cystic fibrosis. Thorax 1997;52:318–21CrossRefGoogle ScholarPubMed
17Lewiston, N, King, V, Umetsu, D, Starnes, V, Marshall, S, Kramer, M et al. Cystic fibrosis patients who have undergone heart-lung transplantation benefit from maxillary sinus antrostomy and repeated sinus lavage. Transplant Proc 1991;23:1207–8Google ScholarPubMed
18Kingdom, TT, Lee, KC, Fitzsimmons, SC, Cropp, GJ. Clinical characteristics and genotype analysis of patients with cystic fibrosis and nasal polyposis requiring surgery. Arch Otolaryngol Head Neck Surg 1996;122:1209–13CrossRefGoogle ScholarPubMed
19Cepero, R, Smith, RJ, Catlin, FI, Bressler, KL, Furuta, GT, Shandera, KC. Cystic fibrosis–an otolaryngological perspective. Otolaryngol Head Neck Surg 1987;97:356–60CrossRefGoogle Scholar
20Marks, SC, Kissner, DG. Management of sinusitis in adult cystic fibrosis. Am J Rhinol 1997;11:11–4CrossRefGoogle ScholarPubMed
21Rajapaksa, SP, Ananda, A, Cain, T, Oates, L, Wormald, PJ. The effect of the modified endoscopic Lothrop procedure on the mucociliary clearance of the frontal sinus in an animal model. Am J Rhinol 2004;18:183–7CrossRefGoogle ScholarPubMed
22Ramsey, B, Richardson, MA. Impact of sinusitis in cystic fibrosis. J Allergy Clin Immunol 1992;90:547–52CrossRefGoogle ScholarPubMed