Online Poster Portal

  • Author
    Christine Liu
  • Co-Author

    Christine M. Liu, BS,  Han EJ, Fischer JL, Mace JC, Mattos JL, Markarian K, Alt JA, Bodner TE, Chowdhury NI, Eshaghian PH, Getz AE, Hwang PH, Khanwalkar A, Kimple AJ, Lee JT, MD, Li DA, Norris M, Nayak JV, Owens C, Patel ZM, Poch, Schlosser RJ, Smith KA, Smith TL, Soler ZM, Suh JD, MD, Turner GA, Wang MB, Taylor-Cousar JL, Saavedra MT, and Beswick DM, MD

  • Abstract Title

    Patient Perspectives on Chronic Rhinosinusitis in Cystic Fibrosis: Symptom Prioritization in the Era of Highly Effective Modulator Therapy

  • Abstract Description

    Area of Concentration: Rhinology

    Keywords: cystic fibrosis, chronic rhinosinusitis, endoscopic sinus surgery, highly effective modulator therapy, patient symptoms, symptom importance, patient priorities

     

    Background: Chronic rhinosinusitis (CRS) is common in people with cystic fibrosis (PwCF). Rhinologic symptom prioritization and areas that influence CRS treatment choices, including pursuing endoscopic sinus surgery (ESS), remain understudied.

    Objectives: To identify the most important symptoms that drive PwCF to seek treatment CRS and to assess potential differences in symptom priorities between: 1) PwCF who elected ESS versus those who continued medical therapy (CMT) for CRS; and 2) PwCF treated with elexacaftor/tezacaftor/ivacaftor (ETI) versus those not on ETI.

    Methods: Adult PwCF+CRS were enrolled at eight centers into a prospective, observational study (2019-2023). Participants were administered the 22-SinoNasal Outcome Test (SNOT-22) survey and a modified SNOT-22 instrument examining symptom importance. We determined importance rankings for individual symptoms and SNOT-22 symptom importance subdomains in two sets of subgroups – those pursuing ESS vs. CMT, and those on ETI vs. not on ETI.

    Results: Among 69 participants, the highest priorities were nasal congestion (n=48, 69.6% important), post-nasal discharge (32, 46.4%), facial pain (29, 43.3%), waking up tired (27, 39.1%), and fatigue (26, 37.7%). Those electing surgery (n=23) prioritized sleep and psychological dysfunction symptoms compared to those pursuing CMT (n=49) [sleep median score = 19.0 (IQR: 12.0, 25.0) vs. 4.5 (0.0, 12.8); p<0.0001; psychological: 17.0 (7.0, 26.0) vs. 7.0 (0.0, 15.8); p=0.002]. ETI users had comparable SNOT-22 total symptom importance scores to non-ETI users (p=0.14). Non-ETI users (n=34) showed a trend toward prioritizing sleep symptoms compared to ETI users (n=35) (13.0 (2.8, 22.3) vs. 6.0 (2.0, 17.0); p=0.055).

    Conclusions: Nasal congestion and post-nasal discharge were top priorities reported by PwCF+CRS. Those electing surgery prioritized sleep and psychological symptoms, highlighting their importance in pre-operative discussions. Non-ETI users’ prioritization of sleep improvement may highlight their unique disease impact and therapeutic needs, however additional investigation is required.

  • Project Specialty (Please select one)

    Surgical Subspecialties

Back