Upper airways

Question

Dear expert team,
our daughter (4.5 years, CF) has mainly problems with the upper airways. Last december, the adenoids have been operated. When she has a rhinitis, this lasts for weeks (in spite of Cefuroxim TS, a herbal expectorant and nose shower). What else can we do to make it easier for her? We have the impression, that the rhinitis is going to be better in between and then worsening again. Decongestant nose drops should only be given for a short time. We fear a worsening of the ventilation of the lungs due to the long times of rhinitis. Many thanks in advance!

Answer

Hello,
children with CF suffer to a very different extent from complaints of the upper airways. Unfortunately, repeated operative treatments are necessary. This should however be avoided by intensive conservative measures as possible. According to the individual situation of the single patient, there are different possiblities for an intensive therapy. This depends to a certain extent also on the type of colonization with germs. I assume that your daughter has no colonization with Pseudomonas aeruginosa up to now. All enumerated measures in the following have certainly to be discussed with your CF center.
1) Cortisone containing nose drops can be used for an interval of 4 weeks a time.
2) Inhalations with the Pari-Sinus with DNAse through the nose can be implemented.
3) As last attempt, an inhalation with an antibiotic drug trough the nose could be tried according to the findings of germs.
In general, it is also very important, that operations in the nose region at CF patients are done by experienced and on this field trained ENT-physicians.
Yours sincerely,
Dr. H.-G. Posselt

08.06.2009