Impact of posttraumatic stress disorder on rhinosinusitis symptom scores

Objectives: The study aimed to examine whether patients with chronic rhinosinusitis (CRS) who suffered from posttraumatic stress disorder (PTSD) had more impaired health-related quality of life (HRQL) than CRS patients without PTSD and what specific symptoms and HRQL domains were worse in PTSD/CRS patients. Methods: The study included 30 patients with CRS and 30 patients with PTSD/CRS. All subjects completed a Sino-Nasal Outcome Test (SNOT-22), visual analogue scale, and a 36-item Short Form Health Survey. All patients underwent a CT scan of the paranasal sinuses that was assessed with the Lund-Mackay score. Results: The overall SNOT-22 score for the PTSD/CRS group was significantly higher than for the CRS group (66.3 vs. 44.9). Scores for the two groups did not differ for the subscale of physical symptoms; while, the PTSD/CRS patients had significantly poorer results on the subscale of emotions, fatigue, and sleep. Respondents in the PTSD/CRS group who experienced more pain had significantly higher total scores on the Lund-Mackay test. Conclusions: Dividing the SNOT-22 into two subscales had diagnostic value in distinguishing the two groups. Obstruction of the paranasal sinuses and nasal cavity is associated with severe pain in patients with PTSD/CRS. Based on the tests used, the therapeutic options for patients with poor scores can be determined more precisely so that PTSD/CRS patients are not exposed to unnecessary diagnostic and therapeutic procedures. It may also be necessary to revise the diagnosis and consider a possible comorbidity of PTSD in CRS patients who do not respond to therapy.