The impact of a patient's age on the clinical presentation of inflammatory paranasal sinus disease.

OBJECTIVE: To determine the change in the clinical presentation of inflammatory paranasal sinus disease as a function of a patient's age. STUDY DESIGN AND METHODS: This is a prospective study of 514 adult patients who presented with inflammatory paranasal sinus disease. The patients were divided into three age groups: group 1 (age: 18-39 years; n=203), group 2 (age: 40-59 years; n=213) and group 3 (age greater than 60 years; n=98). The following data were collected: presenting symptoms, co-morbidities, nasal endoscopy and CT findings, diagnosis, and the outcome of endoscopic sinus surgery (ESS). Statistical analysis was performed using chi-square test, with statistical significance set at p<0.05.
RESULTS: Among the presenting symptoms, facial pain and rhinorrhea were most common in group 1 (p<0.05), while dysosmia was most common in group 3 (p<0.05). Environmental allergy, but not asthma, was more prevalent in groups 1 and 2 (p<0.05). Anatomic abnormalities that obstructed the ostiomeatal unit (OMU) were more common in groups 1 and 2 (p<0.05). Chronic rhinosinusitis (CRS) without polyposis was the most common diagnosis in group 1 and CRS with polyposis was the most common diagnosis in groups 2 and 3 (p<0.05). Patients in group 1 reported higher rate of improvement in olfactory function while patients in group 3 reported higher rate of improvement in rhinorrhea following ESS (p<0.05).
CONCLUSIONS: Patients in the 18-39-year age group and diagnosed with CRS are more likely to present with facial pain, suffer from environmental allergy, have anatomic abnormalities in the OMU region, and report improvement in their olfaction following ESS. Patients who are 60 years or older are more likely to present with dysosmia, be diagnosed with CRS with nasal polyposis, and report improvement in rhinorrhea following surgery. Published by Elsevier Inc.