title: Gender-specific differences in chronic rhinosinusitis patients electing endoscopic sinus surgery.
abstract: BACKGROUND
  The objective of this study was to investigate gender-specific differences in chronic rhinosinusitis (CRS) patients electing endoscopic sinus surgery (ESS).
  
  
  METHODS
  This study was a retrospective review of CRS patients electing ESS (2011-2013) at a tertiary-care center.
  
  
  RESULTS
  ESS was elected by 272 patients (mean age 54.6 years; 48.5% female). Mean Lund-Mackay computed tomography (CT) score was 10.9; total 22-item Sino-Nasal Outcome Test (SNOT-22) score was 41.8. Compared to men, women electing ESS had lower CT score (10.1 vs 11.7; p = 0.01) but higher total SNOT-22 score (44.9 vs 39; p = 0.02). Women reported significantly worse postnasal drainage (p < 0.0001) and embarrassment (p = 0.0021). SNOT-22 scores declined with advancing age (women, p = 0.003; men, p = 0.0005). Reduction in CT scores with age was seen only in males (p = 0.03). Stratifying by age, females aged 61 to 80 years had higher SNOT-22 scores compared to male counterparts (p = 0.04), whereas CT scores were similar. More women underwent surgery for CRS without nasal polyps (CRSsNP) (54.9%) whereas more men underwent surgery for CRS with nasal polyps (CRSwNP) (57.4%), but this difference missed statistical significance (p = 0.052). Women with CRSwNP had higher SNOT-22 scores than men (p = 0.02) for similar CT scores. Men electing ESS for CRSsNP had higher CT scores than women (p = 0.02). Women with CRSsNP aged 18 to 40 years reported higher SNOT-22 scores than men (p = 0.003), even though CT scores were lower (p = 0.005).
  
  
  CONCLUSIONS
  Equivalent numbers of men and women underwent ESS for CRS. Overall, women electing ESS had higher total SNOT-22 scores and lower Lund-Mackay CT scores than men. Women reported more problems with postnasal drainage (CRS overall, CRSsNP, and CRSwNP), embarrassment (CRS overall and CRSwNP), and facial pain (CRSwNP). Gender differences in CRS are poorly understood and merit further study.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic in Arizona, Phoenix, AZ.
authors.forename: Devyani
authors.initials: D
authors.lastname: Lal
authors.affiliation: Keck School of Medicine, University of Southern California, Los Angeles, CA.|Division of Allergy, Asthma, and Clinical Immunology, Mayo Clinic in Arizona, Phoenix, AZ.
authors.forename: Alexis B
authors.initials: AB
authors.lastname: Rounds
authors.affiliation: Division of Allergic Diseases, Mayo Clinic in Rochester, Rochester, MN.
authors.forename: Rohit
authors.initials: R
authors.lastname: Divekar
mesh_terms: D002908:Chronic Disease; D017558:Elective Surgical Procedures; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications / Q000453:epidemiology* / Q000601:surgery; D012189:Retrospective Studies; D012220:Rhinitis / Q000150:complications / Q000453:epidemiology* / Q000601:surgery; D012225:Rhinoplasty; D012737:Sex Factors; D012852:Sinusitis / Q000150:complications / Q000453:epidemiology* / Q000601:surgery; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: SNOT-22; age; chronic rhinosinusitis; chronic sinusitis; endoscopic sinus surgery; gender; patient characteristics