Analysis of the Gender Differences in Patients With Recurrent Acute Rhinosinusitis

Prior evidence has shown that female patients with chronic rhinosinusitis (CRS) suffer a worse disease-specific quality of life (QoL).

To study the gender-specific differences on the QoL of patients with recurrent acute rhinosinusitis (RARS).

Retrospective cohort study of patients presenting to the otolaryngology clinic with RARS defined by at least one objective evidence of rhinosinusitis (CT scan or endoscopy findings). Patients' characteristics and comorbidities were reviewed. The sinonasal outcome test (SNOT-22) and its subdomains were analyzed for gender-based differences at baseline and after surgical treatment.

One hundred and sixteen patients with RARS were included (mean age of 41.1 years, 65.5% female). There was no difference in CT scores (3.7 vs. 4.9, p = 0.162) or endoscopy scores (2.8 vs. 2.6, p = 0.707). Female patients were significantly more likely to have autoimmune, headache, and anxiety disorders (p < 0.05 for all). Females had significantly worse baseline SNOT-22 scores (50.6 vs. 39.1, p = 0.001) and for subdomain scores except the rhinologic and extrarhinologic subdomains, which were similar between groups. SNOT-22 scores were comparable after surgical treatment (SNOT-22 score of 28.7.6 vs. 22.9, p = 0.229), with significant interval improvement from baseline for both groups (p < 0.001; p = 0.002). Multivariate regression analysis of the SNOT-22 scores and its subdomains adjusting for confounders showed that female gender was independently associated with worse QoL (SNOT-22: coeff. 8.4, 95% CI of 2.2-14.7).

Female patients with RARS show higher subjective disease burden. Further research is warranted to elucidate the biological and psychosocial mechanisms underlying these differences.