Depression Influences Treatment of Some Nasal DisordersMood disorders such as depression have been found to undermine treatment of some nasal conditions including allergies and chronic rhinosinusitis.

However, a new study finds that the same mental health disorders do not influence treatment for conditions associated with nasal obstruction such as deviated septum.

Researchers from the Henry Ford Health System discovered that patients with nasal obstruction caused by septal deviation — a blockage of the nasal airway caused by a portion of cartilage or bony septum — who do not have signs and symptoms of allergic rhinitis, would not benefit from depression screening if nasal treatment is unsuccessful.

“Although the literature supports more negative outcomes of allergic rhinitis and chronic rhinosinusitis patients with mood disorders, our data does not show a similar relationship for septal deviation,” said study author Lamont R. Jones, M.D.

“It’s unclear why depression would exacerbate symptoms after certain nasal procedures, but not others; although it’s very likely that the difference could be due to the inflammatory nature of rhinosinusitis and seasonal allergies.”

The study will be presented this week at the Combined Otolaryngological Spring Meetings in San Diego.

Nasal obstruction is a common complaint among patients in otolaryngology (ear, nose and throat) clinics. It is often caused by inflammation from inhalant allergies, mucosal edema from chronic rhinosinusitis, and mechanical obstruction from a deflected septum.

Typical treatment strategies range from nasal saline irrigations, topical corticosteroid sprays, allergy control to surgery. However, even after treatment, some patients continue to have symptoms.

According to some research reports, many of these difficult-to-treat nasal patients may also have a mood disorder.

While the effect of depression on chronic rhinosinusitis has been widely reported – with patients requiring longer follow-up and having less satisfaction with nasal and sinus surgery outcome – little was known about the effect of mood disorders on nasal obstruction symptoms and surgical outcomes.

In the new study, Jones and Brandon Musgrave, M.D., conducted a retrospective review of 437 patients who had surgery between 2005 and 2010 for septal deviation at Henry Ford.

Among the patients, 398 (91 percent) had a successful surgical outcome for nasal obstruction, while 39 (nearly 9 percent) did not.

Within the surgical success group, 31 percent had a comorbid mood disorder, compared to 36 percent of the surgical failures.

However, this variation in mood disorder prevalence was not statistically significant.

According to study findings, the only significant result was that successfully treated nasal obstruction patients had shorter postoperative followup.

That finding, Jones said, is to be expected as patients with persistent nasal symptoms are more likely to continue following up with their surgeon for potential relief.

Source: Henry Ford Health System

Nose photo by shutterstock.