LUND-MACKAY STAGING COMPARED WITH A SINO-NASAL QUALITY OF LIFE TOOL (SNOT)

Abstract

Background Computed tomography (CT) is the imaging modality of choice for evaluating disease of the paranasal sinuses.1 The Lund-Mackay staging system measures stages of chronic rhinosinusitis (CRS). The sino-nasal outcome test (SNOT) covers a range of health-related quality of life problems associated with sinus disease, including physical problems, functional limitations, and emotional consequences.2 Both tools were found to be reliable and valid.2,3 Objective The objective of this study was to determine a relationship between quantitative measures (Lund-Mackay) and a qualitative tool (SNOT). Materials and Methods Institutional review board approval was granted, and 300 patients who had previously undergone CBCT imaging studies were invited to participate. Lund-Mackay scoring was assessed for completely clear, partly opaque, or completely opaque sinuses visualized on CBCT examinations. The SNOT consists of 20 questions pertaining to rhinologic symptoms and psychological function. All patients signed an informed consent form before taking the survey. Using ordinal scales from 0 to 5, patient symptoms were scored for both rhinologic and psychological function: no problem = 0; very mild problem = 1; mild or slight problem = 2; moderate problem = 3; severe problem = 4; and, finally, problem as bad as can be = 5. Higher scores represent worse symptoms and poorer quality of life. The American Society of Anesthesiologists (ASA) and seasons categories were also collected.4 Results Seven (63.6%) males and 4 (36.82%) females participated in the survey. Mean age of the patients was 55.82 ± 17.9. The Mann-Whitney test was used to compare the median result for the survey questions. Patients’ response for “Wake up at night?” was significant (P = .012). Spearman rho correlation showed age as being highly correlated to sinusitis (r = 0.894; P = .0001). Discussion Because both the Lund-McKay system and the SNOT have been demonstrated to be effective for assessment of sinus disease, the Lund-McKay staging system may be appropriate for quantitative assessment where imaging is otherwise required. The SNOT can be used for correlation of patients’ qualitative experiences.