Abstract
Pupillary light reflex (PLR) and heart rate variability (HRV) parameters can be objective indicators of chronic rhinosinusitis (CRS) status from the viewpoint of autonomic nervous system activity. This study aimed to establish objective indicators for CRS using the 22-item Sino-Nasal Outcome Test (SNOT-22) and PLR/HRV parameters. Sixty-seven patients were prospectively and longitudinally followed up after surgical treatment. We investigated changes in SNOT-22 scores, representing CRS-specific quality of life (QOL). We prepared two models: linear regression model adjusting clinical factors as predictor variables (model 1) and linear mixed-effects model adjusting clinical factors and among-individual variability (model 2). We compared Akaike’s information criterion (AIC) values and regression coefficients. The model with lower AIC values was defined as the better-fit model. Model 2 showed lower AIC values in all parameters (better-fit model). Three parameters showed opposite results between the two models. The better-fit models showed significances in the five PLR parameters but not in any HRV parameters. Among these PLR parameters, constriction latency can be the most robust indicator because of the narrowest 95% confidence intervals. Adjusting the among-individual variability while investigating clinical potential of PLR/HRV parameters to reflect CRS-specific QOL can improve the model fit, thereby reaching robust conclusions from obtained data.
Highlights
Pupillary light reflex (PLR) and heart rate variability (HRV) parameters can be objective indicators of chronic rhinosinusitis (CRS) status from the viewpoint of autonomic nervous system activity
To establish PLR/HRV parameters as objective indicators reflecting CRS status, we investigated the association between SNOT-22 total scores and PLR/HRV parameters using two linear regression models
We assessed the association between PLR/HRV parameters and SNOT-22 total symptom scores using two statistical models in this prospective longitudinal study targeting patients with CRS
Summary
Pupillary light reflex (PLR) and heart rate variability (HRV) parameters can be objective indicators of chronic rhinosinusitis (CRS) status from the viewpoint of autonomic nervous system activity. This study aimed to establish objective indicators for CRS using the 22-item Sino-Nasal Outcome Test (SNOT-22) and PLR/HRV parameters. Abbreviations ACV Average constriction velocity ADV Average dilation velocity AIC Akaike’s information criterion ANS Autonomic nervous system BMI Body mass index COMPASS-31 31-Item Composite Autonomic Symptom Score CRS Chronic rhinosinusitis DELTA Constriction ratio eCRS Eosinophilic chronic rhinosinusitis ESS Endoscopic sinus surgery HF High frequency HRV Heart rate variability INIT Initial pupil size LAT Constriction latency LF Low frequency LMM Linear mixed-effects model MCV Maximum constriction velocity. The results showed significant correlations between the 22-item Sino-Nasal Outcome Test (SNOT-22) and COMPASS-31 in participants with CRS with nasal polyps These questionnaires can be used as subjective tools for assessing CRS-related ANS dysfunction, they may be subject to bias. To date, no clinical study has explored the association between ANS activity and CRS using objective indicators
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
