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Laryngoscope. 2015 Jul;125(7):1517-22. doi: 10.1002/lary.25108. Epub 2014 Dec 29.

Using preoperative SNOT-22 score to inform patient decision for Endoscopic sinus surgery.

Author information

1
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
2
Division of Rhinology and Sinus Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
3
Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon.
4
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, CA, U.S.A.

Abstract

OBJECTIVES/HYPOTHESIS:

The purpose of this study is to improve patient understanding of surgical outcomes while they make a preference-sensitive decision regarding electing endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS).

STUDY DESIGN:

Prospective observational cohort study.

METHODS:

Patients with CRS who elected ESS were prospectively enrolled into a multi-institutional, observational cohort study. Patients' were categorized into 10 preoperative Sino-Nasal Outcome Test (SNOT-22) groups based on 10-point increments beginning with a score of 10 and ending at 110. The proportion of patients achieving a SNOT-22 minimal clinically important difference (MCID) (9 points) and the percentage of relative improvement (%) for each preoperative SNOT-22 group were calculated. A subgroup analysis based on polyp status was performed.

RESULTS:

A total of 327 patients were included in this study. Patients with a SNOT-22 score between 10 and 19 had the lowest chance of achieving an MCID (37.5%) and received a relative mean worsening of their quality of life (QoL) after ESS (+18.8%). Patients with a SNOT-22 score greater than 30 obtained a greater than 75% chance of achieving an MCID, and there was a relative improvement of 45% in QoL (all < -44.9%) after ESS. Outcomes from the polyp status subgroup analysis were similar to the findings from the overall cohort.

CONCLUSION:

Outcomes from this study suggest that patients with a preoperative SNOT-22 score higher than 30 points receive a greater than 75% chance of achieving an MCID and on average obtain a 45% relative improvement in their QoL after ESS. Patients with SNOT-22 score of less than 20 did not experience improved QoL from ESS.

KEYWORDS:

Endoscopic sinus surgery; SNOT-22; chronic rhinosinusitis; quality of life; shared decision making; sinusitis

PMID:
25546168
PMCID:
PMC4481170
DOI:
10.1002/lary.25108
[Indexed for MEDLINE]
Free PMC Article

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