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Chronic sinusitis less common than reported

Findings indicate a need to better define the condition in order to increase the accuracy of diagnosis and improve treatments.

By Victoria Stagg Elliott, amednews staff. April 5, 2004.

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Chronic sinusitis, usually believed to affect 14% to 16% of the population, may have a much lower prevalence, according to a paper in the March Archives of Otolaryngology -- Head and Neck Surgery.

Mayo Clinic researchers analyzed medical records of Olmstead County, Minn., residents attending their facility and the neighboring Olmsted Medical Center in search of the actual diagnosis rate. They found that chronic sinusitis was more common in women than men. Most diagnoses were made by primary care physicians rather than specialists. And, the average age at diagnosis was 39.

They also found that the prevalence was only 2%.

"It was much lower than we expected," said Ron Shashy, MD, lead author and chief resident in otolaryngology at Mayo.

The study drew praise for attempting to get a handle on a condition that can be difficult to diagnose because its symptoms tend to be nonspecific and mimic several other common complaints. Some experts also said the findings point to the need for a better definition of chronic sinusitis in order to more accurately diagnose and treat it.

"Many of the things that get called chronic sinusitis are most likely something else," said Robert Flaherty, MD, a family physician and staff doctor at the student health service of Montana State University. "The criteria are so vague as to not be helpful at all. Sinus disease exists, but we don't really have very good diagnostic criteria."

But critics said researchers may be comparing apples with oranges. The studies that found the higher prevalence were based on patient self-reporting that may reflect whether they ever believed or were told that they had the disease, not necessarily whether they have it at the moment. This new research looked at the rate of diagnosis by a physician in a specific one-year period.