Author(s)
Hannan Qureshi, MD
Thomas B. Marshall
Ashton Lehmann, MD
Ian Humphreys, DO, FARS
Waleed Abuzeid, MD, FARS
Aria Jafari, MD
Affiliation(s)
University Washington; Eastern Virginia Medical School; Geisinger Health System;
Abstract:
Background: Chronic rhinosinusitis (CRS) has been associated with cognitive dysfunction in several prospective studies. In this scoping review, we examined the extant literature to characterize the relationship between cognitive dysfunction and CRS regarding disease severity and treatment outcomes.
Methods: The search was conducted in EMBASE, PubMed MEDLINE, Web of Science, Cochrane Library, CINAHL, and Global Index Medicus databases and included all relevant studies reporting cognitive impairment data in adult patients with CRS. Two independent reviewers utilized prespecified inclusion/exclusion criteria.
Results: 797 articles were identified on initial search, and 22 met criteria for full-text review. Significant variation existed between studies in the cognitive measures employed. The Cognitive Failures Questionnaire was the most utilized method to assess cognitive function (5/22 studies, 22.7%). Other measures included the Mini-Mental State Examination, Automated Neuropsychological Assessment Metrics, Fatigue Severity Scale, Stroop Color Word Inference Test, and P300 event-related potential assessment. Patients with CRS demonstrate worse overall cognitive function, with inferior performance on measures of reaction time, processing speed, and selective attention. This observed cognitive impairment is associated with CRS-specific quality of life (i.e., SNOT-22 and RDSI scores) and responsive to both medical and surgical intervention.
Conclusion: Although largely heterogenous and descriptive in nature, the available data suggest a link between CRS and higher-order neural processing. This review indicates an urgent need for additional research and CRS-specific neuropsychological outcomes measures of cognitive dysfunction.