Patients with poor mental health have a poorer self-perception of nasal function, according to a study published online in JAMA Facial Plastic Surgery.

Erika Strazdins, from the University of New South Wales in Sydney, and colleagues conducted a cross-sectional study of 495 patients presenting for airway assessment to examine the correlation of poor mental health with perception of nasal function.

Compared to patients with good mental health, the researchers found that those with poor mental health had poorer scores in all patient-reported outcome measures, including the visual analogue scale for the left side (mean, 51 versus 42; P = 0.001), visual analogue scale for the right side (mean, 54 versus 23), Nasal Obstruction Symptom Evaluation Scale (mean, 2.64 versus 1.96), 22-item Sinonasal Outcome Test (mean, 2.14 versus 1.33), nasal obstruction (40.2 versus 23.7%), and nasal function (49.7 versus 31.8%) (all P < 0.001).

There were subclinical differences in nasal peak inspiratory flow, but all other nasal airflow measures were comparable. A similar pattern was seen for low self-esteem, but not dysmorphia.

“Clinicians should be aware that patients with poor mental health reporting obstructed airflow may in part be representing an extension of their negative emotions rather than true obstruction and may require further assessment prior to surgery,” the authors write.