The Impact of Sinus Surgery for Chronic Rhinosinusitis on Concomitant Depression and Anxiety Symptoms: A Systematic Review and Meta-analysis.

IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY International Forum of Allergy & Rhinology Pub Date : 2025-01-15 DOI:10.1002/alr.23528
Xing Yi Cheah, Claire Jing Wen Tan, Brian Sheng Yep Yeo, Nicholas E-Kai Lim, Qian Wei Tan, Marcus Zhe Xuan Teoh, Benjamin Kye Jyn Tan, Iris Rawtaer, Neville Wei Yang Teo, Tze Choong Charn
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Abstract

Background: Both anxiety and depression are prevalent among patients with chronic rhinosinusitis (CRS) and associated with poorer outcomes following treatment for CRS. However, the impact of treatment on CRS on mental health remains uncertain. Therefore, this study seeks to evaluate if surgical intervention for CRS may alleviate comorbid depression and anxiety.

Methods: PubMed, Embase, and Scopus databases were searched for retrospective and prospective cohort studies, cross-sectional studies, and randomized controlled trials relating to CRS treatment using sinus surgery from inception to April 30, 2024, using the Population, Intervention, Comparison, and Outcomes (PICO) framework. Three blinded reviewers selected observational studies and randomized controlled trials investigating levels of depression and anxiety pre- and post-surgical treatment of CRS. Eleven studies comprising 3067 patients were included, of which five studies were quantitatively analyzed. After which, data were extracted from included articles into a structured proforma and the Newcastle-Ottawa Scale was used to evaluate study bias, following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and a PROSPERO-registered protocol (CRD42022351855). Meta-analyses of the ratio of means were conducted in a random-effects model.

Results: Overall, sinus surgery was associated with significant improvement in test scores of depression (ratio of means (ROM) = 1.47, 95% confidence interval [CI] = 1.03‒2.10), anxiety (ROM = 1.10, 95% CI = 0.81‒1.49), and quality of life markers, which are closely correlated to mental health outcomes.

Conclusions: Sinus surgery for CRS may improve mental health outcomes (both depression and anxiety) for patients.

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慢性鼻窦炎鼻窦手术对伴随抑郁和焦虑症状的影响:一项系统回顾和荟萃分析
背景:焦虑和抑郁在慢性鼻窦炎(CRS)患者中普遍存在,并与CRS治疗后较差的预后相关。然而,CRS治疗对心理健康的影响仍不确定。因此,本研究旨在评估手术干预CRS是否可以减轻共病抑郁和焦虑。方法:采用人群、干预、比较和结果(PICO)框架,检索PubMed、Embase和Scopus数据库,检索从开始到2024年4月30日与鼻窦手术治疗CRS相关的回顾性和前瞻性队列研究、横断面研究和随机对照试验。三名盲法评论者选择了观察性研究和随机对照试验,调查CRS术前和术后的抑郁和焦虑水平。纳入11项研究共3067例患者,其中5项研究进行了定量分析。之后,从纳入的文章中提取数据,形成结构化形式,并按照系统评价和荟萃分析的首选报告项目(PRISMA)指南和prospero注册协议(CRD42022351855)使用纽卡斯尔-渥太华量表评估研究偏倚。采用随机效应模型对均数比率进行meta分析。结果:总体而言,鼻窦手术与抑郁(均值比(ROM) = 1.47, 95%可信区间[CI] = 1.03-2.10)、焦虑(ROM = 1.10, 95% CI = 0.81-1.49)和生活质量指标的测试分数显著改善相关,这些指标与心理健康结局密切相关。结论:鼻窦手术可以改善CRS患者的心理健康状况(抑郁和焦虑)。
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来源期刊
CiteScore
11.70
自引率
10.90%
发文量
185
审稿时长
6-12 weeks
期刊介绍: International Forum of Allergy & Rhinologyis a peer-reviewed scientific journal, and the Official Journal of the American Rhinologic Society and the American Academy of Otolaryngic Allergy. International Forum of Allergy Rhinology provides a forum for clinical researchers, basic scientists, clinicians, and others to publish original research and explore controversies in the medical and surgical treatment of patients with otolaryngic allergy, rhinologic, and skull base conditions. The application of current research to the management of otolaryngic allergy, rhinologic, and skull base diseases and the need for further investigation will be highlighted.
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