Sinonasal Symptom Correlation With the Postoperative Polyp Scale (POPS)

Ann Otol Rhinol Laryngol. 2024 May;133(5):485-489. doi: 10.1177/00034894241232475. Epub 2024 Feb 12.


Background: Commonly used endoscopic nasal polyp grading scales have been shown to correlate poorly with symptom scores and quality of life metrics. The recently described Postoperative Polyp Scale (POPS) is a grading system that more accurately characterizes polyp recurrence in postoperative sinus cavities by describing incremental recurrence in relation to the surgically opened sinus cavities.

Objective: The objective of this study was to determine if the POPS correlated with sinonasal symptoms.

Methods: CRSwNP patients were prospectively administered SNOT-22 questionnaires and graded according to the POPS starting at their 1-month postoperative appointments. Total POPS scores (sum of each side) and Max POPS score (larger value of left and right) were correlated with SNOT-22 total scores and subdomains using Kendall correlation testing.

Results: A total of 127 patients were enrolled in the study. Both Total POPS or Max POPS were significantly correlated to the SNOT-22 total score (P < .001, P < .001), Rhinologic (P < .001, P < .001), Extra-Nasal Rhinologic (P < .001, P < .001), Ear/Facial (P < .001, P < .001), and Psychologic (P = .028, P = .017) subdomains. Kendall's tau indicated strong correlation (≥0.3) with Rhinologic subdomain, moderate correlation (.21-.29) with Extra-Nasal Rhinologic and Ear/Facial subdomains, and weak correlation (.1-.19) with Psychologic subdomain.

Conclusion: Previous endoscopic nasal polyp grading scales poorly correlate with symptoms and patient reported outcome measures. The new POPS moderately correlates with the total SNOT-22 score and strongly correlates with the Rhinologic subdomain, indicating that it may have good potential as a tool to evaluate postoperative CRSwNP patients.

Keywords: SNOT-22; chronic rhinosinusitis; endoscopic sinus surgery; endoscopy; grading; nasal polyps; postoperative; rhinologic; scales; sinonasal; sinusitis.

MeSH terms

  • Chronic Disease
  • Endoscopy
  • Humans
  • Nasal Polyps* / diagnosis
  • Nasal Polyps* / surgery
  • Quality of Life
  • Rhinitis* / surgery
  • Sinusitis* / surgery