Five-item Sino-Nasal Outcome Test in Evaluation of Disease Burden in Chronic Rhinosinusitis With Nasal Polyps

Background: Subjective and objective evaluations of chronic rhinosinusitis with nasal polyps (CRSwNP) are often discordant. Objective: This study aimed to investigate the feasibility of using a newly developed five-item Sino-Nasal Outcome Test (SNOT-5) to evaluate disease severity and to compare its results with objective assessments in patients with CRSwNP. Methods: Adult patients with bilateral CRSwNP planning to undergo sinus surgery were prospectively enrolled. The nasal polyp score (NPS), Lund-Mackay (L-M) score, olfactory cleft opacification (OC) score, and the 22-item Sino-Nasal Outcome Test (SNOT-22) questionnaire were assessed. The SNOT-5 scores were retrospectively extracted from the SNOT-22 results. Three-month postoperative endoscopic modified Lund-Kennedy (MLK) scores and SNOT-22 data were collected when available. Results: A total of 169 participants were enrolled. The SNOT-5 score rather than the SNOT-22 score, was significantly correlated with objective measurements of disease burden, including NPS, L-M, and OC scores. SNOT-5 score was significantly associated with younger age, comorbid asthma, NPS, L-M, and OC scores in the univariate regression analysis, and with age, L-M, and OC scores in the multivariate analysis. Additionally, the SNOT-5 score also significantly correlated with the MLK score at 3 months after surgery. Conclusion: The SNOT-5, rather than the SNOT-22, correlated more closely with objective measures of disease burden, including the NPS and L-M scores, and postoperative MLK score in patients with CRSwNP. Utilizing the SNOT-5 in clinical practice may help clinicians more accurately assess disease severity and treatment response in patients with CRSwNP.