Scoping review demonstrates measurable cognitive impairment in adults with chronic rhinosinusitis, indicating neuroinflammatory effects that partially reverse after targeted treatment.
Background Cognitive dysfunction is increasingly recognized as an extra‐nasal manifestation of chronic rhinosinusitis (CRS). This scoping review characterizes the primary evidence on cognition in adult CRS, covering measures, treatment response, and incident dementia. Methods We searched EMBASE, PubMed/MEDLINE, Web of Science, the Cochrane Library, CINAHL, and Global Index Medicus through May 2026 using a MeSH and free‐text strategy. Inclusion criteria include primary studies of adult CRS with a formal clinical diagnosis (AAO‐HNS, EPOS or ICD‐coded) reporting at least one validated cognitive measure or recognized cognitive impairment. Two reviewers screened independently. Animal studies, reviews, conference abstracts, and non‐CRS populations were excluded. PRISMA‐ScR reporting was performed; heterogeneity precluded meta‐analysis. Results Twenty‐four primary studies met inclusion criteria. Adults with CRS perform worse than controls on subjective (Cognitive Failures Questionnaire [CFQ], Neuro‐QoL) and objective (Montreal Cognitive Assessment [MoCA], Automated Neuropsychological Assessment Metrics [ANAM], eye movement assessment, P300) cognitive instruments. Deficits correlate with disease‐specific QoL severity (SNOT‐22, Rhinosinusitis Disability Index [RSDI]). Cognitive measures improve after medical therapy or endoscopic sinus surgery. Two resting‐state fMRI analyses identified altered orbitofrontal‐precuneus connectivity scaling with sinonasal inflammation. Dementia results are mixed: a UK Biobank analysis (7176 CRS cases among 364,945 participants) reported increased Alzheimer disease risk (HR 1.33), while two Korean cohorts and a 2025 meta‐analysis found no association. Conclusion Adults with CRS show measurable cognitive dysfunction that may improve with treatment, with a plausible neuroinflammatory pathophysiology. Whether this translates to incident dementia is contested. Outcome heterogeneity limits synthesis; therefore, development of a CRS‐specific cognitive measurement set is recommended.
No takes yet. Share an insight, caveat, or question.
O’Neil et al. (2026) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: