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

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 t...

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Autores principales: Bequignon, Emilie, Dupuy, Laurence, Escabasse, Virginie, Zerah-Lancner, Francoise, Bassinet, Laurence, Honoré, Isabelle, Legendre, Marie, Devars du Mayne, Marie, Crestani, Bruno, Escudier, Estelle, Coste, André, Papon, Jean-François, Maître, Bernard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780341/
https://www.ncbi.nlm.nih.gov/pubmed/31546861
http://dx.doi.org/10.3390/jcm8091495
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author Bequignon, Emilie
Dupuy, Laurence
Escabasse, Virginie
Zerah-Lancner, Francoise
Bassinet, Laurence
Honoré, Isabelle
Legendre, Marie
Devars du Mayne, Marie
Crestani, Bruno
Escudier, Estelle
Coste, André
Papon, Jean-François
Maître, Bernard
author_facet Bequignon, Emilie
Dupuy, Laurence
Escabasse, Virginie
Zerah-Lancner, Francoise
Bassinet, Laurence
Honoré, Isabelle
Legendre, Marie
Devars du Mayne, Marie
Crestani, Bruno
Escudier, Estelle
Coste, André
Papon, Jean-François
Maître, Bernard
author_sort Bequignon, Emilie
collection PubMed
description 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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spelling pubmed-67803412019-10-30 Follow-Up and Management of Chronic Rhinosinusitis in Adults with Primary Ciliary Dyskinesia: Review and Experience of Our Reference Centers Bequignon, Emilie Dupuy, Laurence Escabasse, Virginie Zerah-Lancner, Francoise Bassinet, Laurence Honoré, Isabelle Legendre, Marie Devars du Mayne, Marie Crestani, Bruno Escudier, Estelle Coste, André Papon, Jean-François Maître, Bernard J Clin Med Article 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. MDPI 2019-09-19 /pmc/articles/PMC6780341/ /pubmed/31546861 http://dx.doi.org/10.3390/jcm8091495 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bequignon, Emilie
Dupuy, Laurence
Escabasse, Virginie
Zerah-Lancner, Francoise
Bassinet, Laurence
Honoré, Isabelle
Legendre, Marie
Devars du Mayne, Marie
Crestani, Bruno
Escudier, Estelle
Coste, André
Papon, Jean-François
Maître, Bernard
Follow-Up and Management of Chronic Rhinosinusitis in Adults with Primary Ciliary Dyskinesia: Review and Experience of Our Reference Centers
title Follow-Up and Management of Chronic Rhinosinusitis in Adults with Primary Ciliary Dyskinesia: Review and Experience of Our Reference Centers
title_full Follow-Up and Management of Chronic Rhinosinusitis in Adults with Primary Ciliary Dyskinesia: Review and Experience of Our Reference Centers
title_fullStr Follow-Up and Management of Chronic Rhinosinusitis in Adults with Primary Ciliary Dyskinesia: Review and Experience of Our Reference Centers
title_full_unstemmed Follow-Up and Management of Chronic Rhinosinusitis in Adults with Primary Ciliary Dyskinesia: Review and Experience of Our Reference Centers
title_short Follow-Up and Management of Chronic Rhinosinusitis in Adults with Primary Ciliary Dyskinesia: Review and Experience of Our Reference Centers
title_sort follow-up and management of chronic rhinosinusitis in adults with primary ciliary dyskinesia: review and experience of our reference centers
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780341/
https://www.ncbi.nlm.nih.gov/pubmed/31546861
http://dx.doi.org/10.3390/jcm8091495
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