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Laryngoscope. 2015 Aug;125(8):1779-84. doi: 10.1002/lary.25318. Epub 2015 Apr 17.

The predictive value of the preoperative Sinonasal Outcome Test-22 score in patients undergoing endoscopic sinus surgery for chronic rhinosinusitis.

Author information

1
Department of Otolaryngology, Guy's and St. Thomas' National Health Service Trust, London, United Kingdom.
2
Division of Otolaryngology-Head and Neck Surgery, Richmond Road Diagnostic and Treatment Centre, University of Calgary, Calgary, Alberta, Canada.
3
Department of Otolaryngology, Royal National Throat Nose & Ear Hospital, London, United Kingdom.

Abstract

OBJECTIVES/HYPOTHESIS:

With the aim of facilitating preference-sensitive decision making regarding elective endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS), we set out to evaluate the predictive value of the 22-item Sinonasal Outcome Test (SNOT-22) patient-reported outcome measure and to compare outcomes of a UK cohort with a similar United States/Canadian-based study.

STUDY DESIGN:

Prospective observational cohort study,

METHODS:

Patients electing ESS in 87 UK hospitals were enrolled. The primary outcome was change in SNOT-22 score 3 months after surgery. Patients were categorized according to baseline SNOT-22 score, and the proportion of patients achieving a SNOT-22 minimal clinically important difference (MCID) of 8.9 was calculated, as well as the percentage change in SNOT-22 score.

RESULTS:

A total of 2,263 patients were included within this study. There was an average 40% reduction in SNOT-22 scores following surgery, and 66% of patients overall achieved the MCID. The proportion of patients achieving the MCID increased significantly with increasing baseline SNOT-22. Patients with a preoperative score of <20 failed to achieve a mean improvement greater than the MCID. Patients with a score of >30 had a greater than 70% chance of achieving the MCID. CRS patients with polyps had greater improvement than patients with CRS without polyps. The predictive value of the SNOT-22 is similar in the UK cohort, although overall patients did not benefit from surgery as much as their North American counterparts.

CONCLUSIONS:

Medically recalcitrant patients with CRS considering surgery should make decisions guided by their preoperative quality-of-life impairment, as measured by the SNOT-22.

LEVEL OF EVIDENCE:

2b

KEYWORDS:

Chronic rhinosinusitis; Sinonasal Outcome Test-22; endoscopic sinus surgery; outcomes

PMID:
25891944
DOI:
10.1002/lary.25318
[Indexed for MEDLINE]

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