Sino‐Nasal Outcome Test‐22 quality‐of‐life patterns in patients presenting with nasal septal perforation

Leong, Samuel; Webb, Christopher

doi:10.1111/coa.13031

Cited by 15 publications

(25 citation statements)

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“…For example, patients with cocaine-induced NSP may suffer from concomitant atrophic rhinitis and are likely to have increased rhinologic and facial symptoms, which can be compounded by the presence of NSP. 5 Data from this study showed that size of NSP measured by area (cm 2 ) did not demonstrate consistent correlation with total SNOT-22 and NSP-specific domain scores. However, wider A-P diameter and more posteriorly placed NSP resulted in a reduction in total SNOT-22 scores and NSP-specific symptoms, although these were only statistically significant for the latter.…”

Section: Discussioncontrasting

confidence: 59%

“…The mean total SNOT-22 score observed in this study was comparable to other patients diagnosed with CRS, empty nose syndrome, or neurogenic facial pain syndromes. 4,5,9,10 Changes in nasal aerodynamics as a result of the nasal septal defect, coupled with alterations in nasal physiological function and preexisting mucosal disease, may provide some explanation to the etiology of complex sinonasal symptoms and affected well-being observed in this patient group.…”

Section: Discussionmentioning

confidence: 99%

“…At present, there is no specific quality-of-life indicator for NSP. 5 However, previous studies have utilized the Sinonasal Outcome Test-22 (SNOT-22) score to assess the severity of symptoms for nonchronic rhinosinusitis (CRS) diseases including NSP. 5 Although a benign condition, NSP can be distressing to the patients with symptoms of crusting, recurrent epistaxis, whistling, and nasal obstruction.…”

Section: Introductionmentioning

confidence: 99%

“…5 However, previous studies have utilized the Sinonasal Outcome Test-22 (SNOT-22) score to assess the severity of symptoms for nonchronic rhinosinusitis (CRS) diseases including NSP. 5 Although a benign condition, NSP can be distressing to the patients with symptoms of crusting, recurrent epistaxis, whistling, and nasal obstruction. Crusting and bleeding is believed to be caused by changes in air velocity, flow pattern, temperature, and wall shear stress that increases in larger perforations.…”

Section: Introductionmentioning

confidence: 99%

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Correlation of sinonasal symptoms with the size and position of nasal septal perforations

Khong

Leong

2019

The Laryngoscope

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Objective: To assess the correlation of sinonasal symptoms and quality of life with size and position of nasal septal perforation (NSP). Method: This is a prospective observational study in a tertiary referral center involving adult patients presented with NSP. The Sino-Nasal Outcome Test-22 (SNOT-22) and its clinico-psychometric domains were analyzed, including additional NSP-specific symptoms (nasal crusting, epistaxis, and whistling noise during nasal breathing). The size of NSP was measured radiologically by calculating the area in cm 2 and anteroposterior (AP) diameter. Position of perforation was determined clinically by distance from columella to the anterior edge of the perforation. Results: Forty patients were included in this study (22 males). The most common etiology of NSP was iatrogenic. The mean SNOT-22 score was 50.8 (standard deviation 23.8), and mean NSP size was 3.0 cm 2. No statistical correlation was observed between the total SNOT-22 score with either position or size of NSP. As for NSP-specific symptoms, there was a statistically significant negative correlation with the size of perforation (A-P diameter) (r = −0.34, P = 0.03) and position of the perforation (r = −0.49, P = 0.0016), suggesting that these symptoms improved with posterior and larger perforations. Conclusion: Reported SNOT-22 scores were comparable to patients with recalcitrant chronic rhinosinusitis, although the scores did not correlate with size and position of NSP. Sinonasal symptoms typically observed in NSP improved with more posteriorly placed and larger sized perforations. This study provides an insight into the quality-of-life impact of NSP and affirms the clinical observation that anterior NSP are more symptomatic.

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Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Correlation of sinonasal symptoms with the size and position of nasal septal perforations

Khong

Leong

2019

The Laryngoscope

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“…And SNOT-22 version is not yet fully content valid for NSD patients because other nasal symptoms common to NSD patients, such as epistaxis, which we added into our questionnaire, are not included in the current SNOT-22 architecture. Therefore, previous study suggests that further studies be performed to improve the SNOT score ( Leong & Webb, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

A prediction modeling based on SNOT-22 score for endoscopic nasal septoplasty: a retrospective study

Kang

Chen

et al. 2020

PeerJ

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Background To create a nomogram prediction model for the efficacy of endoscopic nasal septoplasty, and the likelihood of patient benefiting from the operation. Methods A retrospective analysis of 155 patients with nasal septum deviation (NSD) was performed to develop a predictive model for the efficacy of endoscopic nasal septoplasty. Quality of life (QoL) data was collected before and after surgery using Sinonasal Outcome Test-22 (SNOT-22) scores to evaluate the surgical outcome. An effective surgical outcome was defined as a SNOT-22 score change ≥ 9 points after surgery. Multivariate logistic regression analysis was then used to establish a predictive model for the NSD treatment. The predictive quality and clinical utility of the predictive model were assessed by C-index, calibration plots, and decision curve analysis. Results The identified risk factors for inclusion in the predictive model were included. The model had a good predictive power, with a AUC of 0.920 in the training group and a C index of 0.911 in the overall sample. Decision curve analysis revealed that the prediction model had a good clinical applicability. Conclusions Our prediction model is efficient in predicting the efficacy of endoscopic surgery for NSD through evaluation of factors including: history of nasal surgery, preoperative SNOT-22 score, sinusitis, middle turbinate plasty, BMI, smoking, follow-up time, seasonal allergies, and advanced age. Therefore, it can be cost-effective for individualized preoperative assessment.

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Presenting Symptomatology for Patients With Nasal Septal Perforation: Application of the NOSE‐Perf Scale

2022

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Objective To objectively identify and quantitate presenting nasal symptoms in patients with a septal perforation using the validated NOSE‐Perf scale. Study Design Case series retrospective review. Methods The medical records from August 2018 through January 2022 of patients at a tertiary care academic center with a septal perforation, and who completed the NOSE‐Perf questionnaire, were reviewed. Perforation symptoms were identified and quantified using the 12‐item NOSE‐Perf scale (score range 0–48). NOSE‐Perf findings were correlated to patient demographics, perforation etiology, and perforation length. NOSE‐Perf scores of patients who pursued treatment were compared with those who did not. Results NOSE‐Perf data were collected from 202 patients. Nasal crusting was noted in 94.1% of patients and was the most severe symptom reported (mean 2.9 of 4.0). Nasal congestion, difficulty breathing, and nasal obstruction followed in prevalence and severity. The mean total NOSE‐Perf score was 23.7. Linear regression analysis demonstrated a weakly negative association of NOSE‐Perf score with patient age and weakly positive association with increasing perforation length. NOSE‐Perf scores were significantly higher in women and in patients pursuing treatment. Conclusion This is the first study to use the validated NOSE‐Perf scale to objectively characterize and establish baseline septal perforation symptomatology. The NOSE‐Perf scale can play a role in the standardization of perforation evaluation and treatment outcomes assessment. Laryngoscope, 133:1315–1320, 2023

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Sino‐Nasal Outcome Test‐22 quality‐of‐life patterns in patients presenting with nasal septal perforation

Abstract: This study has assessed the clinimetric and psychometric properties of patients suffering from symptomatic NSP. Future reports should consider inclusion of SNOT-22 data but with the addition of perforation-specific symptoms (nasal crusting, epistaxis, whistling noise).

Cited by 15 publications

References 14 publications

Correlation of sinonasal symptoms with the size and position of nasal septal perforations

Correlation of sinonasal symptoms with the size and position of nasal septal perforations

A prediction modeling based on SNOT-22 score for endoscopic nasal septoplasty: a retrospective study

Presenting Symptomatology for Patients With Nasal Septal Perforation: Application of the NOSE‐Perf Scale

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