What drives depression in empty nose syndrome? A Sinonasal Outcome Test-25 subdomain analysis

The study titled "What Drives Depression in Empty Nose Syndrome? A Sinonasal Outcome Test-25 Subdomain Analysis" investigates the relationship between disease-specific quality of life impairments and the severity of anxiety and depression in patients with Empty Nose Syndrome (ENS). The primary goal of the research was to determine how various aspects of ENS impact psychological distress and to evaluate how these associations change following surgical intervention.

Study Design and Methods

The study included 68 patients diagnosed with ENS, a condition characterized by paradoxical nasal obstruction following excessive surgical removal of nasal tissues. To address ENS symptoms, patients underwent submucosal Medpor implantation, a surgical procedure aimed at improving nasal airflow and function. The impact of ENS on patients' quality of life and psychological status was assessed using the Sinonasal Outcome Test-25 (SNOT-25), the Beck Depression Inventory-II (BDI-II), and the Beck Anxiety Inventory (BAI). Evaluations were conducted one day before surgery and again six months after the procedure.

Results

The study found significant correlations between the severity of anxiety and depression (as measured by BDI-II and BAI scores) and various domains of the SNOT-25, which includes measures of total score, ear/facial symptoms, psychological dysfunction, sleep dysfunction, and empty nose symptoms. Improvements in ENS symptoms were associated with reductions in depression and anxiety. Notably, changes in BDI-II scores post-operatively were correlated with improvements in the SNOT-25’s total score, as well as in the sleep dysfunction and empty nose symptoms domains.

Furthermore, the study identified specific SNOT-25 scores as predictors of moderate-to-severe depression. Scores exceeding 60 on the total SNOT-25, above 18 in the sleep dysfunction domain, and greater than 14 in the empty nose symptoms domain were strong indicators of significant depressive symptoms.

Conclusions

The findings indicate that ENS symptoms significantly affect psychological well-being, and specific quality of life impairments can predict moderate-to-severe depression. The study highlights the importance of addressing both physical and psychological aspects of ENS. Improvements in ENS symptoms, particularly related to sleep dysfunction and empty nose symptoms, were associated with reductions in depression and anxiety. This suggests that targeted management of these symptoms could substantially reduce the psychological burden experienced by ENS patients.

In summary, the research provides important insights into the relationship between ENS and mental health, demonstrating that effective treatment of ENS symptoms can lead to significant improvements in psychological outcomes. The study underscores the need for comprehensive treatment approaches that address both the physical and psychological dimensions of ENS to enhance overall patient well-being.