Contribution of CT-assisted navigation and microdebriders to endoscopic sinus surgery in cystic fibrosis

Summary Objective To demonstrate the interest of CT-assisted navigation and the microdebrider in rhino-sinus surgery for cystic fibrosis. Methods A retrospective study included 20 patients with cystic fibrosis who had undergone endoscopic sinus surgery using CT-assisted navigation and microdebrider between 1998 and 2006. Results Surgery was indicated for the following symptoms resistant to medical management: incapacitating nasal obstruction (n = 18, 90%) and headache or periorbital pain (n = 14, 70%). At 3 years follow-up, six patients (30%) were symptom-free, six (30%) had required re-operation, and symptoms were well controlled by medication in the other eight (40%). Mean initial bilateral surgery time was 61 min. There were no complications. Conclusion The advent of microdebriders and CT-based navigation has improved endoscopic sinus surgery in cystic fibrosis. It has permitted the control of medication-resistant symptoms, especially nasal obstruction and pain. Precision is satisfactory, with reduced surgery time. No major complications have been observed. Two- or three-step surgery is possible where endoscopic anatomic landmarks have suffered alteration. The resultant control of symptoms encourages extending indications, with repeat procedures, in view of improving patients’ quality of life. Further assessment on a larger series will be needed.