engleski

Impact of posttraumatic stress disorder in patients with chronic rhinosinusitis on symptom scores in sinonasal outcome test 22

Posttraumatic stress disorder (PTSD) and chronic rhinosinusitis (CRS) are diseases with a strong impact on the quality of life. Literature data indicate certain comorbidity between PTSD and chronic fatigue syndrome (CFS), as well as high CFS scores in certain patients with CRS. The common hypothesised pathogenic background of PTSD and CRS is reduced hypocampal volume and impaired synthesis of endogenous opioids. This was, however, not confirmed in CRS patients. The hypothesis of this study is that a lower pain threshold, sleeping disorder and higher fatigue scores in PTSD patients deteriorate the total symptom scores in standard tests for CRS, like sinonasal outcome test 22 (SNOT-22), which leads to classification of patients with PTSD and CRS comorbidity into severe rhinosinusitis group, although there is no objective confirmation of such a severe disease with CT scans or endoscopy findings. The study includes 30 patients who were divided in two groups: 1. PTSD/CRS group and 2. CRS group. Criteria for CRS group include either obstruction or hypersecretion/postnasal drip, + hyposmia or facial pressure/headache longer than 3 months, confirmed either by endoscopy and/or CT score Lund-Mackay greater than 5. Therefore, endoscopy and CT scan were performed in all patients. They were also tested by medical outcome survey short form (SF-36), SNOT-22 and VAS scale of present symptoms adjusted to all sinonasal and some general symptoms. Significantly different results of the health perception and sinonasal symptoms were obtained for the two groups in all tests. General health perception tested by SF-36 is 64.5% for CRS group comparing to 31.96 for PTSD/CRS group. SNOT-22 score for CRS is 48.4 and 57.8 for PTSD/CRS group. VAS is 38.6 for CRS and 56.4 for PTSD/CRS group. CRS patients mostly complain of nose congestion, postnasal drip and thick discharge, opposite to PTSD/CRS patients who mostly complain of sleep disorder and night awakening. These results confirmed our hypothesis.

chronic rhinosinusitis; sinonasal outcome test 22; posttraumatic stress disorder

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