Longitudinal improvement and stability of the SNOT-22 survey in the evaluation of surgical management for chronic rhinosinusitis

Int Forum Allergy Rhinol. 2015 Mar;5(3):233-9. doi: 10.1002/alr.21458. Epub 2014 Dec 15.

Abstract

Background: Patients with chronic rhinosinusitis (CRS) have significant quality-of-life (QOL) improvements following endoscopic sinus surgery (ESS). These improvements remain stable and persist between 6 months and 20 months as measured by the Rhinosinusitis Disability Index and the Chronic Sinusitis Survey. There has yet to be an evaluation of the longitudinal stability of the 22-item Sino-Nasal Outcome Test (SNOT-22) after ESS in patients with CRS.

Methods: Adults with medically recalcitrant CRS who were considered surgical candidates were enrolled in a prospective, multicenter, observational cohort study from February 2011 to February 2013. Baseline evaluation of subjects included assessment of clinical characteristics, measures of CRS-specific disease severity, and QOL evaluation using the SNOT-22. Subjects were then re-evaluated at approximately 6-month, 12-month, and 18-month intervals postoperatively. Data was analyzed using repeated measures analysis of variance (ANOVA) with Bonferroni corrections for matched pairwise comparisons.

Results: A total of 110 patients completed baseline evaluations and follow-up for all 3 postoperative time points. Significant improvement in SNOT-22 scores was seen between baseline and 6 months across both SNOT-22 total and subdomain scores (p < 0.001). There was no statistically significant difference between the 6-month, 12-month, and 18-month time points in the total SNOT-22 score or its domains (p ≥ 0.125) for both the entire cohort or subgroups (p ≥ 0.077).

Conclusion: Postoperative improvement in CRS-specific QOL and symptom severity, as measured by the SNOT-22, suggest stability and durability between 6 months and 18 months. Further study on the longitudinal stability of the SNOT-22 past the 18-month time frame will help further refine clinical study of CRS and provide further understanding of temporal improvements following ESS.

Trial registration: ClinicalTrials.gov NCT01332136.

Keywords: endoscopy; outcome assessment; quality of life; sinusitis; therapeutics.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Analysis of Variance
  • Chronic Disease
  • Endoscopy / standards
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Acuity
  • Patient Outcome Assessment
  • Patient Satisfaction
  • Prospective Studies
  • Quality of Life
  • Rhinitis / psychology
  • Rhinitis / surgery*
  • Sinusitis / psychology
  • Sinusitis / surgery*
  • Surveys and Questionnaires

Associated data

  • ClinicalTrials.gov/NCT01332136