Introduction
Chronic rhino sinusitis is defined as inflammation of the mucosa of the nose and paranasal sinuses which lasts for 12 weeks or longer without completes resolution. (1) Chronic rhino sinusitis is one of the most common chronic diseases with an estimated prevalence of 10.4% and usually had a significant impact on patients’ quality of life.(2) There are several subtypes of chronic rhino sinusitis with two major phenotypes: CRS with or without polyps (CRSwNP or CRSsNP, respectively) with a complex and multifactorial for example dental sinusitis, pediatric sinusitis as well as fungal sinusitis among others and people with allergic rhinitis .(3) The impairment of paranasal sinus ventilation and drainage disorders with interacting triad of intrinsic mucosal inflammation; local microbial community; and mucociliary dysfunction leading to a blockage of the osteo-meatal complex in the middle nasal meatus.(4)The chronicity of rhino sinusitis can be aggravated with deviated nasal septum , smoking and impaired immune defense mechanism .(5) Although the chronic rhino sinusitis is not life threating disease but has significant negative influence on patient’s daily activities and emotions and the impact on health related quality of life including physical, social, emotional, cognitive and work has to be proved to be greater than other condition like angina pectoris and chronic obstructive pulmonary disease. (6-7) the chronicity and frequency of classic sino-nasal symptoms play the main reason of decrease in work performance with loss of productivity and impairment of quality of life of the patients. (8-9)In recent years assessment of CRS related quality of life from the patient’s perspective and the way of affection is more important than other procedures such as CT scan. Therefore, evaluation of the impact of chronic rhinosinusitis on the quality of life has become an integral part of the diagnostic protocol and management plan.(10) In regard to its psychiatric effect, two illnesses are associated, depression and generalized anxiety disorder, approximately 30% of the patients with CRS are suffering from these psychiatric conditions, due the chronicity and frequency of the symptoms .(11-12)
The correlation between chronic rhino sinusitis and depression with psychological disorders such as anxiety and mood disorders may be the result of several factors such as the effects of either syndrome on immunity and immune- related illnesses leads to a great burden on quality of life (QOL) mainly due to disturbed sleep , nasal congestion, facial pain and long term medication. (13-14)
Our present study aims to evaluate the quality of life among patients with chronic rhino sinusitis and the risk of developing depression and psychological stress disorder.