Author(s)
Luke Daniel Heiland
Alejandro R. Marrero-Gonzalez
Shaun A. Nguyen
Vinay K. Rathi
Zachary M. Soler
Rodney J. Schlosser
Affiliation(s)
Medical University of South Carolina;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to better understand the impact of medical therapy on headache and facial pain in patients with chronic rhinosinusitis (CRS).
Objectives: This study aims to characterize the effect of medical therapy on headache and facial pain/pressure in the CRS population.
Study Design: Systematic review and meta-analysis.
Methods: CINAHL, PubMed, and Scopus were searched from inception through June 6, 2023, for English language articles reporting headache or facial pain/pressure in CRS patients. Inclusion was restricted to studies reporting results of the medical treatment of CRS in nonsurgical cohorts. Primary outcome measures included the Sinonasal Outcome Test (SNOT-22) and the visual analogue scale (VAS). Meta-analyses of continuous measures (mean), mean difference (?), and proportions (%) were conducted.
Results: The initial search yielded 2,429 unique articles. After a full text of review of 272 articles, 17 studies reporting outcomes for 2,269 patients were included in the meta-analysis. The mean patient age was 48.6 years (range 18.0 – 86.0; 95% CI: 46.5 to 50.6), among which 55.4% [95% CI: 51.5 to 59.4] were male and 82.9% [95% CI: 68.8 to 93.4] had nasal polyposis. SNOT facial pain/pressure scores improved by 1.1 points [95% CI: -1.7 to -0.5; relative reduction 40.4%] with non-biologic therapies and 1.0 point [95% CI: -1.4 to -0.6; relative reduction 54.6%] with biologic therapies. On an 11-point scale, VAS headaches scores improved by 1.8 units [95% CI: -3.3 to -0.3; 42.1% relative reduction] in CRSwNP patients and 1.0 unit [95% CI: -1.7 to -0.3; 54.0% relative reduction] in CRSsNP patients.
Conclusions: Our findings suggest medical therapy significantly reduces facial pain and pressure in the CRS population.