In Reply Mental health is complex, and there may be various domains that influence perception of nasal function. For instance, our research suggests that there is an association between mental well-being and self-esteem, but not between mental well-being and body dysmorphia. Dr Bartley’s suggestion about the association between anxiety and a worse perception of nasal function is well worth consideration, especially given that patients with anxiety often experience symptoms of dyspnoea.1 Our study2 did not evaluate anxiety as a factor influencing perception of nasal function, nor was hyperventilation assessed during the objective nasal function testing, and this makes it difficult for us to comment on the association.
Strazdins E, Harvey RJ. Mental Health and Nasal Function—Reply. JAMA Facial Plast Surg. 2018;20(1):87. doi:10.1001/jamafacial.2017.2046
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