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Postinfectious conditions challenge disease-specificity of SNOT-22

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The Sino-Nasal-Outcome-Test 22 (SNOT-22) questionnaire assesses treatment outcome and health-related quality of life (HRQOL) in patients with chronic rhinosinusitis (CRS). However, given the overlap between CRS and olfaction in terms of nasal function and the definition of CRS, a fundamental question arises: can patients with olfactory dysfunction (OD) stemming from other causes attain SNOT-22 scores similar to those seen in CRS, even in the absence of CRS? Our study aimed to explore whether OD arising from various postinfectious mechanisms challenges the disease-specificity of SNOT-22 for CRS. If so, could focus on scores within specific symptom domains of SNOT-22 prove valuable in distinguishing between different etiologies.

Methods

The study adopted an observational, retrospective cohort design based on prospectively registered patients and related variables using the REDCap platform. 460 patients experiencing OD due to either (1) simple or (2) complex post-COVID-19, (3) postinfectious non-COVID-19, and (4) CRS, were included in the analysis.

Results

The study revealed that the total SNOT-22 score lacks disease-specificity for CRS. This is evident, because complex postinfectious mechanisms resulting from COVID-19 can produce similar symptoms in patients. Notably, elevated total scores were primarily driven by high subdomain scores within the “sleep and cognition” domain.

Conclusions

The application of SNOT-22 as a screening tool needs to be approached with caution, as the total score alone does not provide disease-specific insights. A more thorough exploration of the four symptom domains and the identification of distinctive scoring patterns within the clinical context may prove pivotal in effectively differentiating between various underlying causes.

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Data availability

Raw data are not publicly available to preserve individuals’ privacy under the European General Data Protection Regulation.

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Acknowledgements

Aparna Udupi and Bo Martin Bibby, Institute for Biostatistics, Aarhus University College.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Gødstrup Hospital, University Clinic for Balance, Flavour and Sleep, Hospitalsparken 15, 7400, Herning, Denmark

    Mascha E. Hildebrandt, Patrick R. Møller, Alexander W. Fjældstad & Therese Ovesen

  2. Department of Clinical Medicine, Aarhus University, Palle Juul-Jensen’s Boulevard 82, 8200, Aarhus N, Denmark

    Alexander W. Fjældstad & Therese Ovesen

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  1. Mascha E. Hildebrandt
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  2. Patrick R. Møller
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  3. Alexander W. Fjældstad
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  4. Therese Ovesen
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Contributions

MEH conceptualization, formal analysis, writing—original draft. PRM data curation—review and editing. AWF data curation, software—review and editing. TO conceptualization, methodology, visualization, supervision—review and editing.

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Correspondence to Mascha E. Hildebrandt.

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Hildebrandt, M.E., Møller, P.R., Fjældstad, A.W. et al. Postinfectious conditions challenge disease-specificity of SNOT-22. Eur Arch Otorhinolaryngol 281, 2395–2402 (2024). https://doi.org/10.1007/s00405-023-08385-z

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