|
| Category | References | Description | Level of evidence | Evidence grade | Conclusion |
|
| Sinonasal manifestations in CF | [3, 4]
[5] | Expert opinion
Individual cohort studies | 5
2b | D
B | Sinonasal manifestations are prevalent in almost all CF patients |
|
| Presence of nasal polyps in CF | [10–14, 16]
[15] | Expert opinion
Lower quality cohort study | 5
3b | D
C | Nasal polyps may occur in up to 86% of CF patients |
|
| Radiological evidence of sinus disease in CF | [17]
[59] | Nonconsecutive cohort study
Expert opinion | 3b
5 | C
D | Virtually all CF patients demonstrate radiological evidence of sinus disease |
|
| Radiological abnormalities | [17, 18] | Retrospective chart review | 4 | C | The most prevalent radiological abnormalities in CF are bilateral uncinate process demineralization and medial displacement of the lateral nasal wall |
|
| Failing of medical therapy | [33] | Retrospective cohort study | 2b | B | Many CF patients will ultimately fail medical therapy and undergo sinus surgery |
|
| ESS as a treatment for sinus disease in CF | [11, 37–43] | Retrospective cohort studies, individual case control studies and retrospective chart reviews | 2b, 3, 4 | B-C | ESS is a safe and effective treatment of sinus disease in CF |
|
| Revision sinus surgery | [51] | Retrospective cohort study | 2b | B | A high proportion of CF patients will eventually require revision sinus surgery |
|
|
Risk factors for revision surgery | [51] | Retrospective cohort study | 2b | B | The identification of factors associated with an increased likelihood of need for revision sinus surgery has resulted in equivocal outcomes |
| [52, 53] | Lower quality cohort study | 4 | C | |
|
| Effects of surgery on pulmonary outcomes | [55–58] | Lower quality cohort studies | 4 | C | There is an improvement of pulmonary symptoms and a reduced need for hospitalizations after sinus surgery in CF, but no differences in pulmonary function test outcomes |
|
| Postoperative complications | [38, 39] | Lower quality cohort studies | 4 | C | There is no association between sinus surgery in CF and increased rates of postoperative complications |
|
| Surgical revision rates | [53] | Lower quality cohort study | 4 | C | Surgical revision rates CF patients with polyps are much higher than in those without polyps |
|
