Comorbidities in patients with all-positive symptoms on sinonasal outcomes test quality-of-life instrument.


Journal Article

OBJECTIVES/HYPOTHESIS: The Sinonasal Outcomes Test-20 (SNOT-20) is a validated tool to assess treatment outcomes in patients with chronic rhinosinusitis (CRS). In the clinic, we observed that patients who responded with a positive score on all 20 items of the SNOT-20 questionnaire (pan-positive patients) often did not have evidence of CRS upon workup. Many of these patients had other underlying diseases contributing to their complaints. METHODS: Analysis of prospectively collected data was performed to identify SNOT-20 pan-positive patients and compare them to 100 consecutive non-pan-positive patients who served as the control group. The following parameters were compared between the two patient groups: presence or absence of chronic diseases such as obstructive sleep apnea, depression, anxiety, fibromyalgia, chronic pain, headaches, temporomandibular joint disease, and arthritis--in addition to sinus computed-tomography Lund-McKay scores and nasal endoscopy Lund-Kennedy scores. We also reviewed the medication list of each patient to look for the possible presence of mental illness. Statistical analysis was performed using the chi-squared and Student t test. RESULTS: One hundred twenty-two pan-positive patients were identified in our database collected from 2003 to 2011. Pan-positive patients had higher incidence of depression, fibromyalgia, anxiety, pain, headache, and use of depression medications--and they also had higher SNOT-20 and endoscopy scores when compared to controls (P < 0.05). Pan-positive patients were more likely female (P < 0.05), but age and race differences did not reach statistical significance. CONCLUSION: The SNOT-20 questionnaire assists clinicians to monitor outcomes in patients treated for CRS. However, clinicians should suspect other underlying chronic conditions in SNOT-20 pan-positive patients. LEVEL OF EVIDENCE: 3B.

Full Text

Duke Authors

Cited Authors

  • Caten, A; Johnson, C; Jang, D; Gurrola, J; Kountakis, S

Published Date

  • December 2015

Published In

Volume / Issue

  • 125 / 12

Start / End Page

  • 2648 - 2652

PubMed ID

  • 26153376

Pubmed Central ID

  • 26153376

Electronic International Standard Serial Number (EISSN)

  • 1531-4995

Digital Object Identifier (DOI)

  • 10.1002/lary.25456


  • eng

Conference Location

  • United States