Is Baseline SNOT-22 Able to Predict the Need for Nose or Sinus Surgery? A Prospective Multicenter Study

Objective: Developing reliable and easy-to-use telemedicine tools is essential in primary care. We sought whether Sino-Nasal Outcome Test-22 could predict the need for surgery and localize pathology of rhinology patients and healthy volunteers solely based on the pattern of the baseline Sino-Nasal Outcome Test-22. Methods: Baseline Sino-Nasal Outcome Test-22 from 66 healthy volunteers and 383 rhinology patients was collected blindly prior to diagnosis. Participants were then categorized into 4 groups according to their diagnosis: control, no surgery (i.e. medical condition), functional nose surgery, and sinus surgery. The difference between groups was assessed by a multinomial logistic regression adjusted for age, gender, asthma, tobacco, history of nose surgery, and trauma. Results: The 22 items of Sino-Nasal Outcome Test differed significantly among the 4 groups (P < .05). Control subjects showed the lowest Sino-Nasal Outcome Test-22 scores for all items. Patients requiring sinus surgery and those listed for nose surgery exhibited a specific pattern of Sino-Nasal Outcome Test-22 score. Nasal and extranasal rhinology symptoms were more specific to the diagnosis than psychological or sleep dysfunction domains. Conclusion: Distinct Sino-Nasal Outcome Test-22 patterns were associated with subjects’ diagnosis. SNOT-22 was not only able to score severity but could also localize the disease, orientate the diagnosis, and predict the need for surgical treatment. The Sino-Nasal Outcome Test-22 may be the easy telemedicine tool the primary care needs for a better referral pattern.