Follow-Up and Management of Chronic Rhinosinusitis in Adults with Primary Ciliary Dyskinesia: Review and Experience of Our Reference Centers

被引:11
作者
Bequignon, Emilie [1 ,2 ,3 ,4 ]
Dupuy, Laurence [1 ]
Escabasse, Virginie [1 ,2 ,3 ]
Zerah-Lancner, Francoise [1 ,2 ,3 ,5 ]
Bassinet, Laurence [6 ]
Honore, Isabelle [7 ,8 ]
Legendre, Marie [9 ,10 ,11 ]
du Mayne, Marie Devars [1 ]
Crestani, Bruno [12 ,13 ,14 ,15 ,16 ]
Escudier, Estelle [9 ,10 ,11 ]
Coste, Andre [1 ,2 ,3 ,4 ]
Papon, Jean-Francois [2 ,4 ,17 ,18 ]
Maitre, Bernard [2 ,3 ,6 ]
机构
[1] Henri Mondor Hosp, AP HP, Publ Hosp Network Paris, Intercommunal Hosp Creteil,Dept Otorhinolaryngol, F-94010 Creteil, France
[2] Natl Inst Hlth & Med Res, INSERM, U955, Mondor Inst Biomed Res IMRB, F-94010 Creteil, France
[3] Paris East Univ, Fac Med, F-94010 Creteil, France
[4] CNRS, Natl Ctr Sci Res, ERL 7000, F-94010 Creteil, France
[5] Henri Mondor Hosp, AP HP, Publ Hosp Network Paris, Dept Physiol & Funct Explorat, F-94010 Creteil, France
[6] Intercommunal Hosp Creteil, Dept Pneumol, F-94010 Creteil, France
[7] Cochin Hosp, AP HP, Publ Hosp Network Paris, Dept Pneumol, F-75014 Paris, France
[8] Paris Descartes Univ, Fac Med, F-75014 Paris, France
[9] AP HP, Publ Hosp Network Paris, Dept Embryol, F-75012 Paris, France
[10] Genet Armand Trousseau Hosp, F-75012 Paris, France
[11] Pierre & Marie Curie Univ, Natl Inst Hlth & Med Res, U933, F-75005 Paris, France
[12] Natl Inst Hlth & Med Res, U1152, F-75018 Paris, France
[13] Univ Dept DHU Fibrosis Inflammat & Remodeling Ren, F-75018 Paris, France
[14] LabEx Inflamex, F-75018 Paris, France
[15] Paris Diderot Univ, Fac Med, F-75018 Paris, France
[16] Hop Xavier Bichat, AP HP, Publ Hosp Network Paris, Dept Pneumol, F-75018 Paris, France
[17] Kremlin Bicetre Hosp, AP HP, Publ Hosp Network Paris, Dept Otorhinolaryngol, F-94275 Le Kremlin Bicetre, France
[18] Paris South Univ, Fac Med, F-94070 Le Kremlin Bicetre, France
关键词
primary ciliary dyskinesia; chronic rhinosinusitis; Pseudomonas aeruginosa; QUALITY-OF-LIFE; CYSTIC-FIBROSIS; LUNG INFECTIONS; SINUS; MICROBIOME; BACTERIOLOGY; DIAGNOSIS;
D O I
10.3390/jcm8091495
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Chronic rhinosinusitis is the foremost manifestation in adult patients with primary ciliary dyskinesia (PCD). We present a retrospective series of 41 adult patients with a confirmed diagnosis of PCD followed in our reference centers. As part of the diagnostic work up in our centers, sinus computed tomography scans (CTs) are systematically performed. All patients also undergo a sampling of purulent secretions sampled from the middle meatus under endoscopic view for bacteriological analysis. In our series, CT opacities were consistent in all the patients, as well as mainly partial and located in ethmoid cells (100% of patients) and in maxillary sinuses (85.4% of patients), and stayed stable over time. In the 31 patients who had purulent secretions, bacteriological culture showed at least one bacterium in 83.9% (n = 26). There was no significant difference in positive cultures for Pseudomonas aeruginosa in patients >40 years old versus those <40 (p = 0.17; Fisher). Surgical management was performed in only 19% of patients in order to improve sinonasal mechanical drainage. Our data support the hypothesis that the sinuses can be considered as a bacterial reservoir. From this retrospective study, we have introduced several changes into our routine clinical practice in our reference centers. Based on our analyses, medical and surgical treatments benefit from incorporating bacteriological information and sinonasal symptoms much more than CT scan evaluation alone. All patients now undergo systematically an annual simultaneous bacteriological sampling of the middle meatus and sputum to follow the relationship between ENT and lung disease and to help to antibiotic therapy strategy.
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