What is the SNOT22 questionaire and why do rhinologists use it

Q: What is the nasal subdomain of the SNOT-22?

The nasal subdomain focuses on symptoms related to nasal and sinus function such as nasal blockage, runny nose, thick nasal discharge, loss of smell or taste and facial pressure. These questions reflect the physical burden of sinus disease on nasal breathing and sinus health.

Q: What is the normal range for a SNOT-22 score?

The SNOT-22 score ranges from 0 to 110. Population studies suggest that individuals without significant sinus disease typically have scores below about 20 to 30, reflecting mild background sinonasal symptoms that occur in the general population.

Q: What is the MCID for the SNOT-22 score?

The minimal clinically important difference (MCID) for the SNOT-22 is approximately 8 to 9 points. A change of this magnitude represents a meaningful improvement or worsening in symptoms from the patient’s perspective.

Q: Why do doctors measure SNOT-22 before and after treatment?

Rhinologists use the SNOT-22 questionnaire before and after treatments such as medication or sinus surgery to assess whether symptoms and quality of life have improved in a clinically meaningful way.

Quality of life measures in sino nasal disease

Chronic rhinosinusitis (CRS) is a chronic inflammatory disease that affects the nasal and sinus cavities. To measure the quality of life (QoL) in patients with CRS, researchers typically use disease-specific QoL instruments that are designed to capture the impact of the disease on the patient’s physical, emotional, and social well-being.

The most commonly used instrument for measuring QoL in patients with CRS is the Sino-Nasal Outcome Test (SNOT), which was developed by the Rhinology Research Society. The SNOT 22 questionaire is a validated instrument that asks patients to rate their symptoms, such as nasal obstruction, facial pain, and postnasal drip, on a scale from 0 (no problem) to 5 (problem as bad as it can be). The questionnaire also includes items that assess the impact of CRS on the patient’s daily activities and emotional well-being.

Other disease-specific QoL instruments that are used to measure the impact of CRS on QoL include the Rhinosinusitis Disability Index (RSDI), the Sinonasal Outcome Test-22 (SNOT-22), and the Chronic Sinusitis Survey (CSS). These instruments assess various aspects of QoL, including symptoms, functional limitations, emotional well-being, and social functioning.

In addition to disease-specific QoL instruments, researchers may also use generic QoL instruments to measure the impact of CRS on overall QoL. The most commonly used generic QoL instrument is the Short Form-36 (SF-36), which assesses overall QoL and includes domains such as physical functioning, social functioning, and emotional well-being.

Overall, the choice of QoL instrument used to measure the impact of CRS on QoL may depend on the specific research question, the patient population, and the clinical setting. However, the most commonly used instruments are disease-specific QoL instruments, such as the SNOT 22 questionnaire, which are designed to capture the unique impact of CRS on QoL. Currently, despite some limitations, the SNOT22 are the most widely accepted and researched quality of life tool in chronic rhinosinusitis. The questionaire has also been validated in other sino-nasal disorders. An example of the English version is featured below.

SNOTT 22 English version

SNOT 22 questionaire translations are availiable for clinical practice and research

The Sino-Nasal Outcome Test (SNOT) is a widely used questionnaire for assessing the impact of chronic rhinosinusitis (CRS) on a patient’s quality of life. As the SNOT was developed in English, it has been translated into several other languages to facilitate its use in diverse populations.

To date, the SNOT 22 questionaire has been translated into more than 40 languages, including French, German, Spanish, Chinese, and Korean. These translations have been conducted using established translation and cross-cultural adaptation processes to ensure the validity and reliability of the translated instrument.

The German Translation of the SNOT22 by Prof Tobias Albrecht

Several of these translations have been validated in clinical studies, demonstrating their utility in assessing the impact of CRS on quality of life in different populations. The availability of these translated versions of the SNOT 22 questionaire has facilitated the use of this instrument in international clinical research, allowing for cross-cultural comparisons of CRS outcomes.

In summary, there are more than 40 translations of the Sino-Nasal Outcome Test, which have been validated and used to assess the impact of chronic rhinosinusitis on quality of life in diverse populations around the world.

Our links to the SNOT22 questionaire PDFs for download (for research use):

SNOT22 test characteristics:

Scale 0-5 or 0-110

MCID: 9.8

Subdomains: Nasal, Ear/Facial, Sleep, Function, Emotion

General asymptomatic population: 20 and below

What is the SNOT-22 questionnaire?

The SNOT-22 (Sinonasal Outcome Test-22) is a validated questionnaire used by rhinologists to measure symptoms and quality of life in patients with sinus disease. It includes 22 questions covering nasal symptoms, sleep disturbance, ear symptoms, and emotional wellbeing.

What is the nasal subdomain of the SNOT-22?

The nasal subdomain focuses on symptoms directly related to nasal and sinus function. These include nasal blockage, runny nose, thick nasal discharge, loss of smell or taste, and facial pressure. These questions reflect the physical burden of sinus disease on nasal breathing and sinus health.

What is the emotional subdomain of the SNOT-22?

The emotional subdomain measures the psychological impact of sinonasal disease. Questions address symptoms such as frustration, sadness, irritability, and reduced concentration. Chronic sinus symptoms can affect mood, sleep quality, and overall wellbeing, which is why emotional symptoms are included in the questionnaire.

What is the normal range for a SNOT-22 score?

The SNOT-22 score ranges from 0 to 110, with higher scores indicating more severe symptoms. In population studies, individuals without significant sinus disease typically have scores below about 20–30, reflecting mild background sinonasal symptoms that may occur in the general population.

What is considered a severe SNOT-22 score in chronic sinusitis?

Patients with moderate to severe chronic rhinosinusitis commonly have SNOT-22 scores in the 40–70 range or higher before treatment. These scores indicate a substantial symptom burden and reduced quality of life.

What is the MCID for the SNOT-22 score?

The Minimal Clinically Important Difference (MCID) for the SNOT-22 is generally about 8–9 points. A change of this magnitude represents a meaningful improvement or worsening in symptoms from the patient’s perspective.

Why do doctors measure SNOT-22 before and after treatment?

Rhinologists often measure SNOT-22 before and after treatments such as medication or sinus surgery. Comparing scores over time helps determine whether treatment has produced a clinically meaningful improvement in symptoms and quality of life.