Importance to question sinonasal symptoms and to perform rhinoscopy and rhinomanometry in cystic fibrosis patients

Summary Objectives Cystic fibrosis (CF) patients almost regularly reveal sinonasal pathology. The purpose of this study was to assess association between objective and subjective measurements of sinonasal involvement comparing nasal airflow obtained by active anterior rhinomanometry (AAR), nasal endoscopic findings, and symptoms assessed with the Sino‐Nasal Outcome Test‐20 (SNOT‐20). Methods Nasal cavities were explored by anterior rigid rhinoscopy and findings were compared to inspiratory nasal airflow measured by AAR to quantify nasal patency and subjective health‐related quality of life in sinonasal disease obtained with the SNOT‐20 questionnaire. Relations to upper and lower airway colonization with Pseudomonas aeruginosa, medical treatment, and sinonasal surgery were analysed. Results A total of 124 CF patients were enrolled (mean age 19.9 ± 10.4 years, range 4–65 years). A significant association of detection of nasal polyposis (NP) in rhinoscopy was found with increased primary nasal symptoms (PNS) which include “nasal obstruction,” “sneezing,” “runny nose,” “thick nasal discharge,” and “reduced sense of smell.” At the same time patients with pathologically decreased airflow neither showed elevated SNOT‐20 scores nor abnormal rhinoscopic findings. Altogether, rhinomanometric and rhinoscopic findings are not significantly related. Conclusions Among SNOT‐20 scores the PNS subscore is related to rhinoscopically detected polyposis and sinonasal secretion. Therefore, we recommend including short questions regarding PNS into CF‐routine care. At the same time our results show that a high inspiratory airflow is not associated with a good sensation of nasal patency. Altogether, rhinomanometry is not required within routine CF‐care, but it can be interesting as an outcome parameter within clinical trials. Pediatr Pulmonol. 2017;52:167–174. © 2016 Wiley Periodicals, Inc.