SINUS & POLYPS

Sinusitis is the inflammation of sinus cavities in the cavities of the cheekbones and skull and is very common in children with cystic fibrosis (CF).

Nasal polyps are bundles of tissue that arise from the inflamed lining of the nose and can block the sinuses. Polyps can also block nostrils making it difficult to breathe.

Nasal polyps are found in people with CF but it is also a condition that is experienced by others without the disease, including in asthma.

Other common CF complications in the sinuses are as follows:

• Deviated nasal septum. A crooked septum — the wall between the nostrils — may restrict or block sinus passages, making the symptoms of sinusitis worse.
• Congenital conditions such as a deviated nasal septum can also cause sinus blockages ranging from uncomfortable irritations to life threatening obstructions. Deviated nasal septums can occur from injuries.
• Allergies and hay fever can also result in inflammation of the nasal passages which can also increase risk for sinusitis and can also affect an individual’s breathing.

Sinus involvement may not cause any symptoms but sometimes it can result in facial pain and headaches. There is growing interest in being more proactive with treating sinus involvement in CF as they may act as a reservoir for infections like Pseudomonas aeruginosa and drip down and seed the lung. Treatment of the sinuses include nebulising or douching with saline and/or antibiotics through the nose and an operation to improve drainage. 

Treatment of polyps include topical steroids or surgical removal.

The sinuses are complex and delicate, they are also an intersection for many systems in the body. These conditions can be treated but are difficult to detect.

Sinusitis is also a major issue for post lung transplant patients. Being immunosuppressed increases the risk of chronic sinusitis. Sinusitis in the post transplant patient has the potential for post nasal drip that can infect the lungs, causing pneumonia.  

Additional Resources

CF and Sinuses:

Rhinosinusitis and comorbidities – National Library of Medicine

Chronic Rhinosinusitis – AAFP

Comorbidities in CF: 10 Questions – Patient Care

A clinicopathological classification of granulomatous disorders – BMJ Journals