Jeffrey J Falco1, Andrew J Thomas1, Xuan Quin1, Shaelene Ashby1, Jess C Mace2, Adam S Deconde3, Timothy L Smith2, Jeremiah A Alt4. 1. Sinus and Skull Base Surgery Program, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, UT. 2. Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, Oregon Health and Science University, Portland, OR. 3. Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California, San Diego, San Diego, CA. 4. Sinus and Skull Base Surgery Program, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, UT. jeremiah.alt@hsc.utah.edu.
Abstract
BACKGROUND: Facial pain is a cardinal symptom of chronic rhinosinusitis (CRS) with significant impacts on patient treatment selection, quality of life, and outcomes. The association between facial pain and CRS disease severity has not been systematically evaluated with validated, facial pain-specific questionnaires. Our objective was to measure pain location, severity, and interference in patients with CRS, and correlate these to the location and severity of radiographic evidence of disease. METHODS: Patients with CRS were enrolled into a prospective, cross-sectional study. Patients completed the Brief Pain Inventory Short Form, which is a validated and widely used tool that measures pain location, severity, and interference with daily activities of living. The Lund-Mackay (L-M) computed tomography (CT) scoring system was used to operationalize the radiographic location and severity of inflammation. Facial pain location, severity, and interference scores were correlated to paranasal sinus opacification scores. RESULTS: Consecutive patients with CRS with nasal polyps (CRSwNP; n = 37) and CRS without nasal polyps (CRSsNP; n = 46) were enrolled. No significant relationship was found between the location and severity of reported facial pain and radiographic findings of disease for patients with either CRSwNP or CRSsNP. There was no difference in pain location between patients with and without radiographic disease in a given sinus. CONCLUSION: Facial pain in CRS is not predicted by the radiographic extent of disease. The location and severity of facial pain reported by the patient is not a reliable marker of the anatomic location and severity of sinonasal inflammation. Pain location should not necessarily be relied upon for guiding targeted therapy.
BACKGROUND:Facial pain is a cardinal symptom of chronic rhinosinusitis (CRS) with significant impacts on patient treatment selection, quality of life, and outcomes. The association between facial pain and CRS disease severity has not been systematically evaluated with validated, facial pain-specific questionnaires. Our objective was to measure pain location, severity, and interference in patients with CRS, and correlate these to the location and severity of radiographic evidence of disease. METHODS:Patients with CRS were enrolled into a prospective, cross-sectional study. Patients completed the Brief Pain Inventory Short Form, which is a validated and widely used tool that measures pain location, severity, and interference with daily activities of living. The Lund-Mackay (L-M) computed tomography (CT) scoring system was used to operationalize the radiographic location and severity of inflammation. Facial pain location, severity, and interference scores were correlated to paranasal sinus opacification scores. RESULTS: Consecutive patients with CRS with nasal polyps (CRSwNP; n = 37) and CRS without nasal polyps (CRSsNP; n = 46) were enrolled. No significant relationship was found between the location and severity of reported facial pain and radiographic findings of disease for patients with either CRSwNP or CRSsNP. There was no difference in pain location between patients with and without radiographic disease in a given sinus. CONCLUSION:Facial pain in CRS is not predicted by the radiographic extent of disease. The location and severity of facial pain reported by the patient is not a reliable marker of the anatomic location and severity of sinonasal inflammation. Pain location should not necessarily be relied upon for guiding targeted therapy.
Authors: Robert C Kern; J Pablo Stolovitzky; Stacey L Silvers; Ameet Singh; Jivianne T Lee; David M Yen; Alfred M C Iloreta; Francis P J Langford; Boris Karanfilov; Keith E Matheny; James W Stambaugh; Anna K Gawlicka Journal: Int Forum Allergy Rhinol Date: 2018-01-19 Impact factor: 3.858