Baseline SNOT-22 as Outcome Predictor: a Powerful Tool just at Hand

Introduction: SNOT-22 was initially designed for rhinosinusitis, but was recently validated in various nose conditions. We sought to optimize the use of SNOT-22 by predicting the outcome of patients and healthy volunteers solely based on the pattern of the baseline SNOT-22.
Material and Methods: Sixty-six healthy volunteers and 383 patients presenting to the rhinology clinic of 3 ENT academic departments participated in this prospective cross-sectional multi-centre study. SNOT-22 from all participants were collected blindly prior to diagnosis. Participants were then categorized in 4 groups according to their outcome: control, medical rhinologic condition, functional nose surgery, sinus surgery. Difference between groups was assessed by a multinomial logistic regression adjusted for age, gender, history of nose surgery and trauma.
Results: The 22 items of SNOT differed significantly among the 4 groups (p <0.05). Control subjects showed the lowest SNOT-22 scores for all items. Patients requiring sinus surgery and those listed for nose surgery exhibited a specific pattern of SNOT-22 score. Nasal and extranasal rhinology symptoms were more specific to the diagnosis than psychological or sleep dysfunction domains.
Conclusion: Distinct SNOT-22 patterns were associated to subjects outcome. SNOT-22 was able to differentiate patients from controls, to score severity, and could further provide an accurate description of pathology. Baseline SNOT-22 could help localize pathology in the sinus or in the nose and predict the need for surgical treatment.