Long-term follow-up of patients with facial pain in chronic rhinosinusitis - correlation with nasal endoscopy and CT

Commonly attributed to chronic rhinosinusitis (CRS), facial pain is a frequent present-ing complaint in otolaryngology clinics. This study aimed to investigate nasal endoscopy and CT in a cohort of CRS patients presenting primarily with facial pain and to report on their long-term follow-up. The setting was a busy otolaryngological practice on a small Mediterranean island. A cohort of 305 consecutive patients with chronic rhinosinusitis refractory to maximal medical therapy was assessed clinically, by nasal endoscopy and coronal sinus CT. The primary presenting symptom in 154 of these individuals was facial pain and this paper studied this particular subgroup of CRS patients. Using the Lund-Mckay scoring system, a CT positive for sinusitis was set at 2 or higher. A score of 0 or I was considered negative for sinusitis. The findings in CT positive and CT negative patients were compared. The CT in 61 (40%) patients with facial pain scored positive while 93 (60%) patients had a negative CT. Patients with facial pain as the presenting symptom in rhinosinusitis were significantly less likely to score positive for sinusitis on CT (chi squared test, p