KeypointsSelf‐reported symptom burden is influenced by many non‐disease factors.Fatigue, autonomic dysfunction, psychological and personality factors may also influence sinonasal symptom burden.Use of SNOT‐22 subscale scores rather than it's total score may be more clinically meaningful.INTRODUCTIONThere is poor correlation between self‐reported chronic sinonasal symptoms and clinical findings, and as a result, sinogenic facial pain is often incorrectly diagnosed. This is partially due to the many influences on symptom reporting as seen in patients suffering from psychiatric distress who report increased symptom burden in chronic disease states. This is of particular concern as chronic nasal conditions such as chronic rhinosinusitis (CRS) are responsible for a significant proportion of primary care workload. Epidemiological data cite a population prevalence of up to 16%, resulting in significant healthcare expenditure and substantial societal costs. The precision of prevalence estimates of CRS varies widely, due to inconsistencies in diagnostic criteria, variable use of subjective or objective measures, and whether the diagnostic setting is primary or specialist care. Failure to endorse a definitive diagnosis of CRS using nasal endoscopy or sinus CT‐scan leads to frequent overdiagnosis.The autonomic nervous system plays an important role in regulating the vasculature, secretomotor and inflammatory status of the airway. The nose is
Clinical Otolaryngology – Wiley
Published: Jan 1, 2018
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