Is baseline SNOT-22 able to predict outcome and localize pathology? A prospective multicentre study

Objective: To optimize the use of SNOT-22 by predicting the diagnosis of patients and healthy volunteers solely based on the pattern of the baseline SNOT-22.
Study Design: Cross-sectional multi-center study.
Settings: ENT departments of 3 tertiary referral hospitals.
Methods: Baseline SNOT-22 from 66 healthy volunteers and 383 rhinology patients were collected blindly prior to diagnosis. Participants were then categorized in 4 groups according to their diagnosis: 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 diagnosis. SNOT-22 was not only able to score severity, but could also localize the disease, orientate the diagnosis and predict the need for surgical treatment. In the era of pandemic risk, SNOT-22 may be the easy telemedicine tool the primary care needs for a better referral pattern.