Clinical Practice Using Scoring Systems in Sinonasal Diseases

Abstract

Numerical values are generally used to measure the values of things and to analyze differences in the values. The concept of a scoring system is thought to be useful to better recognize the conditions of patients with certain diseases and is widely used in the medical field. We propose four useful scoring systems for sinonasal diseases: the nasal symptoms questionnaire (NSQ), the self-administered odor questionnaire (SAOQ), the operating score (OP score), and the postoperative endoscopic appearance score (PEAS). The backgrounds and significances of these scoring systems are methodologically and clinically described. The NSQ, consisting of 10 symptoms- and quality of life (QOL)-related items, has been well-verified based on analyses of the predictive validity, test-retest reproducibility, internal consistency reliability, and sensitivity. The SAOQ, consisting of 20 odor-related items selected based on previous olfactory studies, was initially proposed for assessing olfactory function in 2003 by the Japanese Rhinologic Society, and its acceptability, validity, and sensitivity have been statistically validated. The OP score, used to assess the intra-operative severity of sinonasal conditions during endoscopic sinus surgery (ESS), can be a predictor of the postoperative clinical course in patients with chronic rhinosinusitis (CRS); analyses of the concurrent validity of the OP score indicate that CRS patients with more severe operative findings require longer post-operative management. The PEAS, which has been demonstrated to show high-level concurrent validity and inter-rater reliability, can be one of the useful endoscopic sinonasal evaluations in the postoperative period. When the clinical courses can be predicted before treatments using these scoring systems, appropriate treatments can be initiated at an early stage, and consequently, the efficacy of treatments can be improved, in patients with sinonasal diseases.