Sinusitis patients have pain similar to the elderly and people with arthritis

When medicines don't work, researchers say endoscopic surgery can offer relief

CHICAGO, 25 sept 2008 –A new analysis led by researchers at Georgetown University Medical Center suggests many patients with sinusitis have aches and pains similar in severity to people in their 80s and those with arthritis or depression. The study also finds that endoscopic sinus surgery to clear clogged sinuses can bring significant pain relief.
About 14 percent of Americans suffer from sinusitis, an illness that can be chronic and sometimes difficult to treat.
"Bodily pain is not listed as a symptom of chronic sinusitis in general medical texts or journals and as a result, patients are sometimes diagnosed with unrelated conditions such as arthritis, depression, fibromyalgia or chronic fatigue syndrome," says the study's author Alexander C. Chester, M.D., an internist and clinical professor at Georgetown University Medical Center. "Unfortunately, this leaves too many people unaware of treatments for sinusitis that can improve their overall condition."
The purpose of the study, presented today at the 2008 annual meeting of the American Academy of Otolaryngology--Head and Neck Surgery Foundation in Chicago was to determine if elevated levels of bodily pain were associated with sinusitis and to examine whether bodily pain improved following endoscopic sinus surgery.
In the first known review of its kind, Chester and his colleagues performed a meta-analysis of 11 studies which included a general, health-related quality-of-life survey with a separate assessment of bodily pain before and after endoscopic sinus surgery on a scale of 0 (most bodily pain) to 100 (least bodily pain).
"We found that the daily experience of bodily pain was much more common in patients with sinusitis than in the overall population," explains Chester. "Confirmation that aches and pains occur with sinus disease is a relief to many patients who thought they had two separate illnesses."
In addition to their findings about the pervasiveness of pain, a majority of the studies analyzed showed that following endoscopic sinus surgery, postoperative bodily pain scores improved to values similar to that in the general population.
"Having data showing that pain will improve after sinus surgery is particularly helpful when considering the merits of undergoing surgery when medications fail," explains Chester. He says more than 200,000 endoscopic sinus surgeries are done annually in the United States using a technique considered less invasive and much safer than older methods.
"This study highlights an important point: Chronic sinusitis should not be considered as a minor localized disease condition rather, as this study emphasizes, sinusitis can cause serious clinical levels of discomfort in many patients," says Neil Bhattacharyya, MD, otolaryngologist and sinus surgeon at Brigham and Women's Hospital and Harvard Medical School, the study's senior author.
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In addition to Chester and Bhattacharyya, other authors include Raj Sindwani, MD, FRCS, of St. Louis University School of Medicine; and Timothy L. Smith, MD, MPH of Oregon Health and Science University. The authors report no financial disclosures.