Serum High-Sensitivity C-Reactive Protein Is Associated with Postoperative Psychiatric Status in Patients with Empty Nose Syndrome.

Po-Hung Chang,Hung-Chin Chen,Ta-Jen Lee,Chi-Che Huang,Chia-Hsiang Fu

doi:10.3390/diagnostics11122388

Abstract

Many patients diagnosed with empty nose syndrome (ENS) later develop mental illness. The literature addressing biomarkers associated with postoperative psychiatric status is limited. This study aimed to assess the association between high-sensitivity C-reactive protein (hs-CRP) and psychiatric status after surgery in ENS. We recruited patients with ENS undergoing endonasal submucosal implantation. Their pre- and postoperative psychiatric status was evaluated using the Beck depression inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI). Serum hs-CRP was analyzed one day before and one year after surgery. Of the 43 patients enrolled, all subjective measurements had improved (symptom scores decreased) significantly by the third month postoperatively and remained plateaued till 12 months. Those with preoperative hs-CRP levels > 2.02 mg/L were likely to remain depressive 1 year postoperatively. The regression model showed that a preoperative hs-CRP level > 2.02 mg/L was significantly correlated with postoperative depression in patients with ENS (odds ratio, 19.9). Hs-CRP level seems to be a feasible predictor of surgical outcome regarding improved depression in patients with ENS. Patients with higher preoperative hs-CRP levels should be monitored closely after surgery.

Highlights

Empty nose syndrome (ENS) is characterized by a subjective sensation of nasal blockage and suffocation and, paradoxically, a patent nasal cavity [1]
C-reactive protein (CRP) is a systemic marker of inflammation, and it increases in the peripheral blood following infection, trauma, and/or tissue damage [42]
The present study showed that the preoperative high-sensitivity C-reactive protein (hs-CRP) level was associated with postoperative psychiatric outcomes in patients with ENS

Summary

Introduction

Empty nose syndrome (ENS) is characterized by a subjective sensation of nasal blockage and suffocation and, paradoxically, a patent nasal cavity [1]. 1994, and the term was used to describe the wide nasal passages observed on endoscopy or imaging [2]. In addition to nasal and pharyngeal symptoms, such as dyspnea, air hunger, dryness, and hyposmia, ENS causes serious psychological and emotional disorders, such as chronic fatigue, depression, anxiety, and frustration [3]. The diagnosis of ENS by physical examination alone is unreliable. The objective findings correlate poorly with the subjective symptoms of patients with ENS [4]. The improvement of the subjective symptoms became the primary measurement of treatment outcome

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