Nasal Disease Handbook

Cystic Fibrosis

Cystic fibrosis (CF) is a genetically inherited illness affecting 1 out of 2000 Caucasian children. It is present in other races but at a significantly lower incidence. While there are a myriad of problems for people with CF, today's greatest concern is chronic lung disease. Almost all people with cystic fibrosis also have nasal and sinus disease, and this occurs because their mucosa is swollen and their secretions are thick and tenacious. The mucociliary system is not capable of transporting these secretions. They, therefore, stagnate in the nose and paranasal sinuses. They become infected and virtually all people with CF have some degree of chronic sinusitis. The bacteria which grow in the cystic secretions are then inhaled with every breath into the lungs and then contribute to the chronic lung disease. Nasal Irrigation is an excellent tool to help the cystic fibrosis patient irrigate and get rid of their nasal secretions. To be effective the nose must be irrigated at least twice a-day. If the sinuses are involved, I strongly recommend endoscopic sinus surgery, as described in the section on chronic sinusitis. The surgery is designed not only to open the sinuses, but to facilitate the twice-daily nasal irrigations.  Tobramycin is often added to the nasal irrigant once per day.