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16-07-2012 | Surgery | Article

Sorting rhinosinusitis symptoms by ‘SNOT-22’


Free abstract

MedWire News: The three leading symptoms for chronic rhinosinusitis (CRS) are nasal blockage, alterations to smell/taste, and needing to blow the nose, report UK researchers.

However, such symptoms are significantly relieved by surgery and this is the case whether patients have nasal polyposis or not, they say.

"The severity of patient's symptoms and their impact on health-related quality of life can be measured using the Sino-Nasal Outcome Test-22 (SNOT-22), a validated tool which encompasses all major symptoms of the European Paper on Rhinosinusitis and Nasal Polyps," says the team.

However, no prevalence figures for individual symptoms of SNOT-22 have yet been published, say Sala Abdalla (Guy's Hospital, London) and colleagues.

Furthermore, pre- and postoperative severity scores taking into account the presence or absence of nasal polyposis have not been compared, they write in Clinical Otolaryngology.

In an analysis of data from the National Comparative Audit of Surgery for Nasal Polyposis and Chronic Rhinosinusitis, the team examined the prevalence and severity of SNOT-22 symptoms in 2573 CRS patients (1784 with nasal polyposis, 789 without) before and 3 months after they underwent sinus surgery.

Among those with nasal polyposis, the most prevalent symptom was nasal blockage, at 96.5%, followed by altered sense of smell/taste, at 90.3%, and the need to blow the nose, at 79.8%.

Nasal blockage and altered smell/taste were also the most prevalent symptoms among those without nasal polyps, although they were less prevalent than in those with polyposis, at 93.5% and 75.7%, respectively. Waking up tired was the third most prevalent symptom, at 69.9%.

Analysis of the preoperative symptom severity SNOT-22 scores (ranging from 0 for "no problem" to 5 for "as bad as it can be") showed that nasal blockage was the most severe symptom in patients with and without polyposis, at 3.9 and 3.5, respectively. Altered smell/taste was the second most severe, at 3.6 and 2.7, respectively, followed by need to blow the nose, at 2.9 and 2.6, respectively.

The severity score for all three of these symptoms significantly improved in both groups after surgery, reports the team.

Scores for nasal blockage, altered smell/taste, and need to blow the nose improved by 41%, 53%, and 52% in those with nasal polyps and among those without nasal polyps the three scores improved by at least 50%.

Furthermore, the severity score for waking up tired, the third most prevalent symptom in those without polyps, improved by 80%.

"This information is hoped to increase our understanding of the important clinical symptoms in this condition," concludes the team.

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Sally Robertson

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