Mohd Slim Mohd Afiq, Dick David, Trimble Keith, McKee Gary
Department of Ear, Nose and Throat, Royal Victoria Hospital, Belfast, UK.
BMJ Case Rep. 2016 Jun 21;2016:bcr2016214467. doi: 10.1136/bcr-2016-214467.
Patients with cystic fibrosis (CF) are at increased risk of nasal polyps. We present the case of a 17-month-old Caucasian patient with CF who presented with hypertelorism causing cycloplegic astigmatism, right-sided mucoid discharge, snoring and noisy breathing. Imaging suggested bilateral mucoceles in the ethmoid sinuses. Intraoperatively, bilateral soft tissue masses were noted, and both posterior choanae were patent. Polypectomy and bilateral mega-antrostomies were performed. Histological examination revealed inflammatory nasal polyposis typical of CF. The role of early functional endoscopic sinus surgery (FESS) in children with CF nasal polyposis remains questionable as the recurrence rate is higher, and no improvement in pulmonary function has been shown. Our case, however, clearly demonstrates the beneficial upper airway symptom relief and normalisation of facial appearance following FESS in a child with this condition.
囊性纤维化（CF）患者患鼻息肉的风险增加。我们报告一例17个月大的患有CF的白种人患者，该患者表现为眼距过宽导致睫状肌麻痹性散光、右侧黏液性分泌物、打鼾和呼吸嘈杂。影像学检查提示筛窦双侧黏液囊肿。术中发现双侧软组织肿块，双侧后鼻孔通畅。进行了息肉切除术和双侧上颌窦扩大开窗术。组织学检查显示为CF典型的炎性鼻息肉病。早期功能性内镜鼻窦手术（FESS）在CF鼻息肉病儿童中的作用仍存在疑问，因为复发率较高，且未显示出肺功能改善。然而，我们的病例清楚地表明，FESS可使患有这种疾病的儿童上呼吸道症状得到缓解，面部外观恢复正常。
