title: Longitudinal improvement and stability of the SNOT-22 survey in the evaluation of surgical management for chronic rhinosinusitis.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, CA.
authors.forename: Adam S
authors.initials: AS
authors.lastname: DeConde
authors.forename: Jess C
authors.initials: JC
authors.lastname: Mace
authors.forename: Jeremiah A
authors.initials: JA
authors.lastname: Alt
authors.forename: Luke
authors.initials: L
authors.lastname: Rudmik
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Soler
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
mesh_terms: D000704:Analysis of Variance; D002908:Chronic Disease; D004724:Endoscopy / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062072:Patient Acuity; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012220:Rhinitis / Q000523:psychology / Q000601:surgery*; D012852:Sinusitis / Q000523:psychology / Q000601:surgery*; D011795:Surveys and Questionnaires
keywords: endoscopy; outcome assessment; quality of life; sinusitis; therapeutics