a1 Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
a2 Division of Otolaryngology, VA Boston HealthCare System, Boston, Massachusetts, USA
a3 Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
Study objective: To determine the impact of a patient's gender on the clinical presentation of chronic rhinosinusitis with and without nasal polyposis.
Study design and methods: Prospective study of 514 adult patients who presented with chronic rhinosinusitis with and without nasal polyposis. The patients were divided into two groups based on gender: female (n = 273) and male (n = 241). The following data were collected: presenting symptoms, co-morbidities, nasal endoscopy and sinus computed tomography findings, diagnosis, and outcome of surgery. Statistical analysis was performed using the chi-square test, with statistical significance set at p < 0.05.
Results: Facial pain and headache were more prevalent among women, while nasal obstruction was more prevalent among men (p < 0.05). There was no statistically significant difference in the prevalence of environmental allergy, asthma, psychiatric illness or anatomical variants obstructing the osteomeatal unit, comparing the genders. Chronic rhinosinusitis without polyposis was the more common diagnosis among women, while chronic rhinosinusitis with polyposis was the more common diagnosis among men (p < 0.05). Following surgery, a higher percentage of male patients reported improvement in nasal obstruction (p < 0.05), but there was no statistically significant difference in the improvement of the other presenting symptoms, comparing the genders.
Conclusion: Women who suffer from chronic rhinosinusitis are more likely to complain of facial pain or headache on presentation and to be diagnosed with chronic rhinosinusitis without polyposis. On the other hand, men are more likely to complain of nasal obstruction, to be diagnosed with chronic rhinosinusitis with polyposis, and to report improvement in nasal obstruction following surgery.
(Accepted September 17 2007)
(Online publication January 10 2008)
c1 Address for correspondence: Dr Nicolas Y Busaba, Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston MA 02114, USA. Fax: +1 617 573 3914 E-mail: [email protected]
Dr N Y Busaba takes responsibility for the integrity of the content of the paper.
Competing interests: None declared