Editorial: The psychological impact of sinonasal pathology

Sinonasal pathology, including rhinosinusitis with or without nasal polyps, rhinitis, nasal septal deviations, or sinonasal tumors, is commonly encountered in otorhinolaryngological practice.Historically, their assessment has focused predominantly on physical manifestations such as nasal obstruction, rhinorrhea, facial pain, olfactory deficits, or breathing impairment.However, an emerging body of evidence highlights that rhinosinusal pathology can have a significant impact on the psychological status of these patients.The associated emotional and mental health consequences warrant further attention and integration into our clinical paradigm. Is there a strong association between sinonasal pathology and psychologic problems?Recent literature increasingly supports the bidirectional relationship between sinonasal pathology and psychological well-being.Patients with persistent nasal and sinus symptoms or recurrent infections often report decreased quality of life (QoL), poor sleep, and cognitive fatigue.These physical symptoms, in turn, contribute to or exacerbate psychiatric symptoms including anxiety, depressed mood, irritability, and social withdrawal.Meta-analytic evidence reveals that depression afflicts 24.7% of chronic rhinosinusitis (CRS) patients (95%CI, 21.3% to 28.1%), while anxiety affects nearly 29.7% (95%CI, 19.3% to 40.2%), with higher prevalence rates observed in clinical cohorts relative to community samples (higher rates in female patients with 36.1% (95%CI, 25.3% to 46.9%) and in patients without nasal polyps 26.2% (95%CI, 21.9% to 30.5%)) 1 .A large Korean nationwide cohort study including 21,707 patients with CRS and 86,828 controls demonstrated a higher incidence of depression in the CRS group when compared to controls (9.8% vs 5.2%, p < 0.001; adjusted hazard ratio of 1.41, 95% CI 1.33-1.48) 2 .