title: Validation of the sino-nasal outcome test-23 in septorhinoplasty surgery.
abstract: There has been a great expansion in patient-based outcome measures to face the ever-increasing demand to demonstrate surgical efficacy. However, surgeons have not adopted until now any systematic outcome instrument. The 22-item Sino-Nasal Outcome Test (SNOT-22) is a validated sinonasal outcome score in sinonasal and septorhinoplasty surgery but does not measure aesthetic outcome. The aim of this paper is to validate a modification to the Sino-Nasal Outcomes Test-22 (SNOT-22) with a new question regarding the shape of the nose (SNOT-23).
  
  
  
  We conducted a prospective cohort study on 69 consecutive patients undergoing septorhinoplasty and a control group of healthy volunteers. Reproducibility, responsiveness to treatment, known group differences and validity of the SNOT-23 were analysed. Scores were compared to visual analogue scales, nasal obstruction symptoms evaluation (NOSE) score and nasal inspiratory peak flow.
  
  
  
  SNOT-23 has good test-retest reliability and is a valid outcome measure for assessing response to surgery especially with regards to shape of the nose and nasal obstruction when compared to other patient reported measures.
  
  
  
  SNOT-23 is a valid and reliable tool that can be easily used in routine clinical practice to assess the functional and aesthetic outcomes from septorhinoplasty surgery. The SNOT-23 could be adopted as a universal, easy to use tool in rhinology clinics for the assessment of response to septorhinoplasty and sinus surgery.
authors.affiliation: Department of Facial Plastics and Rhinology, The Royal National Throat, Nose and Ear Hospital, London, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Takhar
authors.affiliation: Department of Facial Plastics and Rhinology, The Royal National Throat, Nose and Ear Hospital, London, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Stephens
authors.affiliation: Department of Facial Plastics and Rhinology, The Royal National Throat, Nose and Ear Hospital, London, United Kingdom.
authors.forename: P S
authors.initials: PS
authors.lastname: Randhawa
authors.affiliation: Department of Facial Plastics and Rhinology, The Royal National Throat, Nose and Ear Hospital, London, United Kingdom.
authors.forename: A L
authors.initials: AL
authors.lastname: Poirrier
authors.affiliation: Department of Facial Plastics and Rhinology, The Royal National Throat, Nose and Ear Hospital, London, United Kingdom.
authors.forename: P
authors.initials: P
authors.lastname: Andrews
mesh_terms: D006801:Humans; D015508:Nasal Obstruction / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery*; D059747:Nasal Surgical Procedures / Q000379:methods* / Q000592:standards; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D012225:Rhinoplasty / Q000295:instrumentation* / Q000592:standards; D011795:Surveys and Questionnaires