Lund-mackay staging system in cystic fibrosis: a prognostic factor for revision surgery?

Ochsner J. 2014 Summer;14(2):184-7.


Background: Cystic fibrosis (CF) is an autosomal recessive genetic disease that affects approximately 30,000 people in the United States. Mucus in CF patients can be exceptionally viscous, leading to progressive cycles of inflammation and infection. The most widely accepted staging system used to score sinus computed tomography (CT) scans is the Lund-Mackay Score (LMS).

Methods: To determine if a significant correlation exists between LMS and the need for revision sinus surgery in a patient population with CF, we performed a retrospective review of 32 patients with CF who were referred to the Tulane Otolaryngology Clinic from 2005 to 2011 and received a CT scan of the paranasal sinuses. CT scans were graded in a blinded manner by the institution's neuroradiologist using the LMS system.

Results: We found no statistically significant difference in the raw or scaled LMSs between patients receiving revision surgery (n=9) and patients receiving a single surgery (n=23).

Conclusions: CT scans are vital for preoperative planning, but they are not a useful tool for risk stratification. More specifically, application of the LMS is not relevant in identifying which CF patients with chronic rhinosinusitis will be at risk for revision surgeries.

Keywords: Cystic fibrosis; paranasal sinuses; surgical procedures–operative; tomography–x-ray computed.