Comparison of SNOT-25 and ENS6Q in evaluating patients with empty nose syndrome

Chien-Chia Huang; Pei-Wen Wu; Cheng-Chi Lee; Chi-Che Huang; Chia-Hsiang Fu; Po-Hung Chang; Ta-Jen Lee

doi:10.1002/lio2.767

Comparison of SNOT-25 and ENS6Q in evaluating patients with empty nose syndrome

Laryngoscope Investig Otolaryngol. 2022 Feb 28;7(2):342-348. doi: 10.1002/lio2.767. eCollection 2022 Apr.

Authors

Chien-Chia Huang^{1

2

3}, Pei-Wen Wu^{1

2

4}, Cheng-Chi Lee^{2

5

6}, Chi-Che Huang^{1

2

3}, Chia-Hsiang Fu^{1

2

3}, Po-Hung Chang^{1

2

3}, Ta-Jen Lee^{1

2

7}

Affiliations

¹ Division of Rhinology, Department of Otolaryngology Chang Gung Memorial Hospital Linkou Taiwan.
² School of Medicine, Chang Gung University Taoyuan Taiwan.
³ Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University Taoyuan Taiwan.
⁴ Department of Otolaryngology-Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University Keelung Taiwan.
⁵ Department of Neurosurgery Chang Gung Memorial Hospital Linkou Taiwan.
⁶ Department of Biomedical Engineering National Taiwan University Taipei Taiwan.
⁷ Department of Otolaryngology Xiamen Chang Gung Hospital Xiamen China.

Abstract

Objectives: Patients with empty nose syndrome (ENS) experience paradoxical nasal obstruction and various psychological burdens. This study aimed to compare ENS-specific questionnaires of sino-nasal outcome test-25 (SNOT-25) and empty nose syndrome 6-item questionnaire (ENS6Q) in the peri-operative evaluation of ENS.

Methods: This was a prospective case series study. Patients with ENS were recruited and evaluated with the SNOT-25, ENS6Q, beck depression inventory-II (BDI-II), and beck anxiety inventory (BAI) before and 6 months after nasal reconstruction surgery.

Results: Seventy-four ENS patients were enrolled during the study period. All four evaluations revealed significant improvements after surgery. Pre-operative SNOT-25 scores exhibited a significant correlation with pre-operative ENS6Q (r = 0.682), BDI-II (r = 0.485), and BAI scores (r = 0.608) (p < 0.001), as well as a weak correlation with post-operative SNOT-25 (r = 0.336), BDI-II (r = 0.266), and BAI scores (r = 0.235) (p < 0.05). Additionally, pre-operative ENS6Q scores were significantly correlated with pre-operative BDI-II (r = 0.434), BAI (r = 0.521) (p < 0.001), and post-operative ENS6Q scores (r = 0.262, p < 0.05). However, there was no correlation between pre-operative ENS6Q scores and post-operative BDI-II and BAI scores.

Conclusions: Both SNOT-25 and ENS6Q were helpful in evaluating peri-operative symptoms for patients with ENS. Although the ENS6Q score had a good correlation with the BDI-II and BAI scores preoperatively, it was not associated with post-operative BDI-II and BAI scores. Hence, a simultaneous psychological assessment is necessary when evaluating patients using the ENS6Q.Level of Evidence: 2c.

Keywords: Beck anxiety inventory; Beck depression inventory II; Sino‐nasal outcome test‐25; empty nose syndrome; empty nose syndrome 6‐item questionnaire.