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A systematic review of patient-reported nasal obstruction scores: defining normative and symptomatic ranges in surgical patients. JAMA Facial Plast Surg 2014 May-Jun;16(3):219-25; quiz 232

Date

03/08/2014

Pubmed ID

24604253

Pubmed Central ID

PMC4072745

DOI

10.1001/jamafacial.2013.2473

Scopus ID

2-s2.0-84901722311   94 Citations

Abstract

IMPORTANCE A gold standard objective measure of nasal airway obstruction (NAO) does not currently exist, so patient-reported measures are commonly used, particularly the Nasal Obstruction Symptom Evaluation (NOSE) scale and the visual analog scale (VAS). However, questions remain regarding how best to use these instruments. OBJECTIVES To systematically review studies on NOSE and VAS scores in patients with NAO and to compile and standardize the data to (1) define symptomatic and normative values for presurgical and postsurgical patients with NAO, asymptomatic individuals, and the general population; (2) determine if postsurgical scores are comparable with asymptomatic scores; and (3) determine if there is a clinically useful preoperative and postoperative score change. EVIDENCE REVIEW A systematic review of the literature was performed through PubMed for studies assessing NOSE and VAS scores in patients with chronic NAO. Strict inclusion criteria were applied to focus on anatomic obstruction only. For statistical analysis, the patients were classified as asymptomatic, presurgical and postsurgical with NAO, and the general population. FINDINGS The mean (SD) NOSE and VAS scores for a patient with NAO were 65 (22) and 6.9 (2.3), respectively. The mean postsurgical NOSE and VAS scores were 23 (20) and 2.1 (2.2), respectively. The mean asymptomatic individual NOSE and VAS scores were 15 (17) and 2.1 (1.6). The mean NOSE and VAS scores for the general population were 42 (27) and 4.6 (2.6), respectively. The mean presurgical to postsurgical change was more than 40 for NOSE scores and more than 4.0 for VAS scores. CONCLUSIONS AND RELEVANCE We have shown that normative and abnormal value ranges for NOSE and VAS can be established for clinical use. Given the consistency of both scales, we conclude that these measures can be used as a clinically meaningful measure of successful surgical outcomes.

Author List

Rhee JS, Sullivan CD, Frank DO, Kimbell JS, Garcia GJ

Authors

Guilherme Garcia PhD Assistant Professor in the Biomedical Engineering department at Medical College of Wisconsin
John S. Rhee MD Chair, Professor in the Otolaryngology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Humans
Nasal Obstruction
Pain Measurement
Rhinoplasty
Self Report
Treatment Outcome
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a