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Higgins TS, Shutt TA, Ting JY, Illing EA, Tang DM, Kosaraju N, Potts K, Cash L, Liu D, Sheeley KA, Wu AW. Development of the 12-Item Facial Complaints Evaluation Scale (FaCES-12). Ann Otol Rhinol Laryngol 2024; 133:495-502. [PMID: 38380629 PMCID: PMC11022522 DOI: 10.1177/00034894241233034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
OBJECTIVES Chronic rhinosinusitis and related rhinologic disorders are common in routine otolaryngologic practice. Common presenting symptoms include nasal obstruction, facial pain, facial pressure, headache, and a subjective feeling of the face feeling "swollen," a perceptual distortion. No validated scale exists to assess facial pain in addition to perceptual distortion or headache. The objective was to develop a novel scale for assessment of facial symptoms experienced by patients presenting for rhinologic evaluation. METHODS This was a prospective validation cross-sectional study. A patient questionnaire, the 12-item Facial Complaints Evaluation Scale (FaCES-12), was created to evaluate facial symptoms based on clinical experience and the literature, including severity and timing of facial pain, facial pressure, facial perceptual swelling, and headache. Each item was assessed utilizing an 11-point Likert scale ranging from 0 to 10 in severity. Data was collected prospectively from 210 patients in 1 private and 2 academic otolaryngologic practices from August to December 2019 along with the PROMIS Pain Intensity Scale 3a and 22-Item Sino-nasal Outcome Test. Construct validity was determined using Pearson correlation and exploratory factor analysis. Internal consistency and test-retest reliability were assessed by calculating Cronbach's alpha and assessing test-retest scores. RESULTS A new 12-item scale named FaCES-12 was developed. FaCES-12 demonstrated high reliability with a Cronbach's alpha of .94 and high test-retest reliability (r = .90). The scale revealed very strong correlation with the PROMIS Pain Intensity Scale 3a (r = .81) and moderate correlation with the Sino-nasal Outcome Test (r = .48). Exploratory factor analysis demonstrated the scale contained interrelated variables that measured unique components of facial sensations. CONCLUSION The FaCES-12 is a valid and reliable instrument for use in the evaluation of facial symptoms. Further research into the application of this scale is warranted.
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Affiliation(s)
- Thomas S. Higgins
- Department of Otolaryngology—Head and Neck Surgery, University of Louisville School of Medicine, Louisville, KY, USA
- Rhinology, Sinus & Skull Base, Kentuckiana Ear, Nose & Throat, Louisville, KY, USA
| | - Travis A. Shutt
- Department of Otolaryngology—Head and Neck Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - Jonathan Y. Ting
- Department of Otolaryngology—Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Elisa A. Illing
- Department of Otolaryngology—Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Dennis M. Tang
- Department of Otolaryngology—Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Nikitha Kosaraju
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kevin Potts
- Department of Otolaryngology—Head and Neck Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - Liz Cash
- Department of Otolaryngology—Head and Neck Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - David Liu
- Department of Otolaryngology—Head and Neck Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - Kathleen A. Sheeley
- Rhinology, Sinus & Skull Base, Kentuckiana Ear, Nose & Throat, Louisville, KY, USA
| | - Arthur W. Wu
- Department of Otolaryngology—Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Lin HL, Lee YC, Wang SH, Chiang LY, Liu JF. In Vitro Evaluation of Facial Pressure and Air Leak with a Newly Designed Cushion for Non-Invasive Ventilation Masks. Healthcare (Basel) 2020; 8:E523. [PMID: 33271748 DOI: 10.3390/healthcare8040523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 11/16/2022] Open
Abstract
Background: The aim of this study was to evaluate the effect of a newly designed foam cushion on the air leakage and pressure when applied to the face. Methods: A teaching manikin connected to a bilevel positive airway pressure ventilator attached to four different brands of oronasal masks (Amara, Mirage, Forma, and Wizard) was used. The foam cushions of 5-mm and 10-mm-thickness were attached to the masks, and each mask was tested without a cushion. Six pressure sensors were placed on the manikin’s face, and data were recorded. Inspiratory volume and air leak flow from the ventilator were observed. Results: Air leakage was influenced by both the mask brand and the presence of a cushion. The presence of a cushion did not affect the Wizard mask in terms of leakage (p = 0.317) or inspiratory volume (p = 0.726). The Wizard and Amara masks generated the lowest contact pressure on the frontal forehead (p < 0.001) compared to the other five points. Conclusions: Utilisation of a cushion reduces air leakage and maintains greater inspiratory volume regardless of its thickness. The contact pressure varies depending on the brand of the mask, which would require a difference in the thickness of the cushion for pressure reduction.
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Alam ES, Musselman DL, Chyou D, Shukri G, Levine CG, Sanghvi S, Zhang H, Casiano RR. Somatization, Depression, and Anxiety Disorders in a Rhinology Practice. Am J Rhinol Allergy 2019; 33:470-477. [PMID: 30947506 DOI: 10.1177/1945892419841317] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Patients present to rhinology clinics with various complaints. Symptoms may be attributable to objective findings, some remain unexplained. The objective is to investigate the incidence of psychological disorders in a rhinologic practice and evaluate a correlation of these psychiatric diseases with rhinologic symptoms. Methods Patients presenting to a rhinology clinic were administered the Generalized Anxiety Disorder 7 (GAD 7), Patient Health Questionnaire 9 (PHQ 9), and PHQ 15, psychometric instruments that can screen for generalized anxiety, major depression, and somatization disorder, respectively. Patients’ symptoms, endoscopic findings, medication, and psychiatric history were recorded. Multivariable analysis was performed for patients showed moderate-to-severe anxiety, depression, and somatic symptoms via 3 logistic regressions where the outcome was a GAD 7, PHQ 9, or PHQ 15 above 10. Results One hundred ninety-six patients were included for this study. There were 109 females and 87 males with a mean age of 49 years. Overall, 9%, 14%, and 21% exhibited moderate-to-severe anxiety, depressive, and somatization symptoms, respectively. Nasal obstruction was the only statistically significant variable that increased the odds of having moderate-to-severe anxiety symptoms. Similarly, headache, nasal obstruction, and anosmia/hyposmia were associated with increased odds of having depressive symptoms, and female gender, headache, and nasal discharge increased the odds of somatic symptom disorder. Edema was the only objective endoscopic finding, which was associated with depression only. Conclusions Patients should be counseled about the pathophysiology and psychiatric comorbidities affecting their primary rhinologic complaints. The provider needs to set realistic treatment expectations in order to achieve the desired clinical outcomes.
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Affiliation(s)
- Elie S Alam
- 1 Department of Otolaryngology, Head and Neck Surgery, Miller School of Medicine, University of Miami, Miami, Florida
| | - Dominique L Musselman
- 2 Department of Psychiatry, Miller School of Medicine, University of Miami, Miami, Florida
| | - Darius Chyou
- 3 Miller School of Medicine, University of Miami, Miami, Florida
| | - Ghaith Shukri
- 1 Department of Otolaryngology, Head and Neck Surgery, Miller School of Medicine, University of Miami, Miami, Florida
| | - Corinna G Levine
- 1 Department of Otolaryngology, Head and Neck Surgery, Miller School of Medicine, University of Miami, Miami, Florida
| | - Saurin Sanghvi
- 1 Department of Otolaryngology, Head and Neck Surgery, Miller School of Medicine, University of Miami, Miami, Florida
| | - Hang Zhang
- 4 Department of Public Health, Division of Biostatistics, University of Miami, Miami, Florida
| | - Roy R Casiano
- 1 Department of Otolaryngology, Head and Neck Surgery, Miller School of Medicine, University of Miami, Miami, Florida
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Lal D, Rounds A, Dodick DW. Comprehensive management of patients presenting to the otolaryngologist for sinus pressure, pain, or headache. Laryngoscope 2014; 125:303-10. [PMID: 25216102 DOI: 10.1002/lary.24926] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/03/2014] [Accepted: 08/20/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVES/HYPOTHESIS To study differential diagnosis and efficacy of management strategies in patients presenting to an otolaryngologist for sinus pressure, pain, or headache. STUDY DESIGN Retrospective analysis at an academic medical center. METHODS Patients were seen in the clinic (2010-2012) for sinus-related headache, pressure, pain or fullness (study symptoms) by a rhinologist. A retrospective chart review of patients with study symptoms was conducted. RESULTS Of 211 patients with study symptoms, 70.62% met American Academy of Otolaryngology-Head and Neck Surgery criteria for sinusitis or had rhinologic disease. Otolaryngic therapy alone (medical or surgical) relieved study symptoms in 51.66%; combined neurology intervention helped another 15.17%. Nearly half of the patients (48.82%) were diagnosed with primary headache disorders. Comorbid rhinologic-neurologic disease was present in 27.96% and odontogenic disease in 7%. Initial otolaryngology referral was likely unnecessary for 36.49% of the study patients. Sinus computed tomography (CT) was available for 91% of 211 patients, and 80% of scans were positive. Endoscopic sinus surgery (ESS) was used in only 80/211 patients (37.69%) and was effective in 66/211 (31.28%). ESS was most successful in patients receiving concurrent neurological intervention. The Lund-Mackay CT score did not predict outcomes from ESS. Interdisciplinary otolaryngology-neurology efforts resulted in a positive outcome for 92.4% of patients. CONCLUSIONS We present the first series detailing management of patients with sinus-headache pain in an otolaryngology practice. Such symptoms have multifactorial etiologies. Positive sinus CT results require cautious interpretation. ESS should be judiciously used. Interdisciplinary care is critical for success: approximately 50% of patients benefited from otolaryngic management, 50% needed neurological treatment, and 7% required dental disease management. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Devyani Lal
- Department of Otolaryngology, Mayo Clinic, Phoenix, Arizona
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