The management of difficult-to-treat chronic rhinosinusitis

Chronic inflammation of the nose and the paranasal sinuses, called chronic rhinosinusitis, affects around 10.7% of the general population. In patients with cystic fibrosis and primary ciliary dyskinesia, this number increases to 83% and 30%, respectively. Chronic bacterial colonization and biofilm formation might contribute to recalcitrance of the disease, leading to persisting symptoms, poor postoperative outcomes, more frequent outpatient visits and increased use of antibiotics. In these patients, standard-of-care therapeutics, including nasal irrigations and intranasal corticosteroids, might not be sufficient and treatment alternatives are sought. 

This PhD project consist of two parts. In the first part, the burden of sinonasal disease in cystic fibrosis patients will be investigated in the era of CFTR modulators. In the second part, treatment alternatives will be evaluated in patients with difficult-to-treat chronic rhinosinusitis. One of these alternatives includes bacteriophage therapy, a treatment  modality using bacteriophages - viruses that are able to infect and kill bacteria - to treat bacterial infections.