The Lund-Mackay staging system for chronic rhinosinusitis: how is it used and what does it predict?

Otolaryngol Head Neck Surg. 2007 Oct;137(4):555-61. doi: 10.1016/j.otohns.2007.02.004.


Objectives: The Lund-Mackay score is widely used in assessment of chronic rhinosinusitis. We aimed to describe its relationship to other measures of pre- and post-treatment health status.

Study design: Multicenter prospective study of 1840 patients undergoing surgery for chronic rhinosinusitis in the UK.

Results: There was no absolute threshold for surgery, but patients with higher Lund-Mackay scores underwent more extensive surgery. There was no correlation between Lund-Mackay and SNOT-22 scores. The Lund-Mackay increased with increasing grade of polyposis. The Lund-Mackay score was associated with symptom reduction (coefficient = 0.24, P = 0.02) complication rates (odds ratio, 1.08, 95%CI 1.06 to 1.1), and revision rates (odds ratio, 1.03, 95% CI 1.001 to 1.06).

Conclusions: The Lund-Mackay score measures a different aspect of disease to "subjective" symptom scores. However, it correlates well with other markers of disease severity, the nature of surgery offered, and its outcome.

Significance: This demonstrates the strengths and limitations of a commonly used staging system.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Aspirin / adverse effects
  • Asthma / complications
  • Chronic Disease
  • Drug Hypersensitivity / complications
  • Female
  • Follow-Up Studies
  • Forecasting
  • Health Status
  • Humans
  • Hypersensitivity / complications
  • Male
  • Middle Aged
  • Nasal Obstruction / classification
  • Nasal Polyps / classification
  • Postoperative Complications
  • Prospective Studies
  • Quality of Life
  • Reoperation
  • Rhinitis / classification*
  • Rhinitis / surgery
  • Severity of Illness Index
  • Sinusitis / classification*
  • Sinusitis / surgery
  • Smoking
  • Tomography, X-Ray Computed


  • Anti-Inflammatory Agents, Non-Steroidal
  • Aspirin