Validation of the Sino-Nasal Outcome Test 20 (SNOT-20) domains in nonsurgical patients

Am J Rhinol Allergy. 2009 Jan-Feb;23(1):40-5. doi: 10.2500/ajra.2009.23.3259.


Background: The objectives of this study were, first, to confirm the presence of multiple domains within the Sino-Nasal Outcome Test 20 (SNOT-20) using a medically treated population, and, second, to reanalyze data from this population to reveal incremental information. A prospective, randomized controlled trial was performed.

Methods: One hundred twenty-seven adults with chronic rhinitis or rhinosinusitis symptoms were treated with nasal saline irrigation or spray. Treatment outcome was quality of life measured with SNOT-20 scores, which were reanalyzed for this study with a factor analysis. Differences in change scores were compared.

Results: Factor analysis confirmed the presence of four domains: psychological function, sleep function, rhinological symptoms, and ear and/or facial symptoms. At 8 weeks after randomization, saline irrigation had significant effects on the rhinological symptom (p = 0.01) and sleep (p = 0.01) compared with saline spray, but no between-group difference was seen in psychological function or ear and/or facial symptom domains.

Conclusion: Subscales identified differences in the impact of two medical interventions on chronic sinonasal symptoms. Reporting subscale scores might improve the precision of the SNOT-20 instrument, allowing discrimination between various treatments and their differential impact on sinonasal quality of life.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Intranasal
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Nasal Lavage / methods*
  • Prospective Studies
  • Quality of Life
  • Reproducibility of Results
  • Rhinitis / complications
  • Rhinitis / diagnosis
  • Rhinitis / drug therapy*
  • Severity of Illness Index
  • Sinusitis / complications
  • Sinusitis / diagnosis
  • Sinusitis / drug therapy*
  • Sodium Chloride / administration & dosage*
  • Treatment Outcome


  • Sodium Chloride