The objective of this study was to perform translation, cross-cultural adaptation, and validation of the SNOT-22 in the Lithuanian language. This is a prospective case-control study. The study was conducted at the University clinic. The sino-nasal outcome test 22 (SNOT-22) was translated into the Lithuanian language; the pilot study involved 34 patients, the test-retest group consisted of 34 patients with chronic rhinosinusitis (CRS), and the control group of 115 patients with no CRS complaints; 36 patients were evaluated before surgery and 3 months after surgery. The results showed a good internal correlation with Cronbach's alpha-0.89 in the initial test, and 0.93 in the retest; both values suggesting good internal consistency within the SNOT-22. Pearson's correlation coefficient was 0.72 (p < 0.001), revealing good correlation between the initial scores and the retests scores. Our sample of healthy individuals had a median score of 12 points, and the instrument was capable of differentiating between the healthy and the patient group, demonstrating its validity (p < 0.0001). The statistically significant reduction in the post-operative scores, vis-à-vis pre-operative values, demonstrates the responsiveness of the instrument. The minimally important difference was 13 points in the SNOT-22 score. The Lithuanian version of the SNOT-22 is a valid instrument for assessing patients with CRS. It demonstrated good internal consistency, reproducibility, validity, and responsiveness.

Background Odontogenic maxillary sinusitis (OMS) and rhinogenic sinusitis (RS) are the main types of chronic rhinosinusitis (CRS) and have a significant impact on health-related quality of life (HRQL), but the difference in HRQL and symptom presentation between them has not been specifically evaluated to date. Obejctive: Our aim was to compare patterns of symptoms and HRQL disease-specific domains in patients affected with these 2 types of CRS. Methods A group of 201 patients with CRS (99 with rhinogenic and 102 with odontogenic origin) completed the Sino-Nasal Outcome Test 22 (SNOT-22) questionnaire before treatment. Data sets were analyzed by using principal component analysis (PCA) to identify a set of symptom components together with the items excluded from PCA, which were then analyzed for differences between patients with OMS and RS. Results PCA of SNOT-22 items identified 5 components: “rhinologic,” “extranasal rhinologic,” “ear/facial,” “sleep and functional disturbance,” and “emotional disturbance.” Sneezing was excluded from PCA and treated as separate outcome variable and was significantly worse in RS patients. Patients with OMS scored significantly higher scores with regard to emotional disturbance, while RS patients scored significantly worse in sleep and functional disturbance. The extra symptom “malodor” was the most different symptom and was significantly worse in OMS patients. The total SNOT-22 score was not significantly different between the groups. Conclusion With controlling of covariates that may influence the severity of the disease, this study showed some significant differences in symptom patterns and HRQL impairment between patients with OMS and RS. Malodor is the most characteristic feature of OMS. Therefore, OMS should always be suspected in patients complaining of bad breath.

Background The treatment of chronic odontogenic and nonodontogenic rhinosinusitis is different. It requires the elimination of odontogenic cause and optimal sinus surgical treatment. To date, there are no clear indications when sinus surgical treatment is necessary. Objective Our aim was to define clear indication(s) for sinus surgical treatment in patients with chronic odontogenic rhinosinusitis after elimination of odontogenic cause. Methods A group of 96 patients with chronic odontogenic rhinosinusitis caused by apical periodontitis completed a Sino-Nasal Outcome Test 22 (SNOT-22) questionnaire with incorporated additional symptom “malodor” before treatment. Moreover, they were distributed according to computed tomography (CT) radiological criteria such as degree of periapical pathology, anatomical ratio between maxillary lateral teeth and sinus floor, sinus mucosal thickening, and ostiomeatal complex condition. The elimination of odontogenic cause was performed by extracting causative tooth. Questionnaire was filled again 2 weeks, 3 months, and 6 months after treatment. All data were analyzed to search the clear indications for sinus surgical treatment. Results Of 96 patients, 74 (77.1%) patients had full resolution of symptoms after dental cause was eliminated. For other 22 (22.9%) patients, symptoms persisted and sinus surgical treatment was indicated. In recovered group, mean SNOT-22 score was different between all periods of measuring, while within nonrecovered group, small differences were seen only when compared to before treatment. No statistically significant correlation between radiological criteria and rhinosinusitis healing after tooth extraction was found ( P > .05). Statistically significant correlation was found between the disappearance of malodor/SNOT-22 score reduction after elimination of dental cause and healing success ( P < .005). Conclusions Our study revealed that extraction of causative tooth is an effective treatment of chronic odontogenic rhinosinusitis caused by apical periodontitis. CT criteria are not valuable indicator for sinus surgery, but persistence of malodor after 2 weeks is the strongest indication for this type of treatment.

Background and objectives: The aim of our study was to analyze the concentrations of inflammatory markers in the nasal tissue of patients with chronic rhinosinusitis with nasal polyps (CRSwNPs) and controls of different age groups, as well as to find associations between age, inflammation development, and NPs. Materials and methods: Patients were divided into two groups—patients with CRSwNPs and control subjects who had nasal surgery for another reason beside CRS. Our analysis was performed across three different age groups (18–30 years, 31–50 years, and 51 years and more). Tissue biopsies from the sinus cavity for all study participants were taken and frozen at −80 °C, until use. The concentrations of IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-10, IL-13, IL-21, and IL-22, were quantified using a magnetic bead-based multiplex assay. Results: In the group aged 18–30 years, the levels of inflammatory markers IL-1, IL-2, IL-5, and IL-22 were significantly higher in patients with CRSwNPs than the control subjects. Among patients aged 31–50 years, significantly higher concentrations of IL-2, IL-4, IL-5, and IL-22 were recorded in patients with CRSwNPs, as compared to the control subjects. In the oldest group (aged 51 years and more), patients with CRSwNPs had significantly higher concentrations of IL-2, IL-4, and IL-22, as compared to the control group. In the CRSwNP group, only the concentration of IL-21 was significantly higher among patients aged 31–50 years, as compared with those aged 51 years and older (p = 0.013). Conclusions: IL-2 and IL-22 levels were significantly higher in patients with CRSwNP than the control, across all age groups. Only the concentration of IL-21 was higher among patients with CRSwNP in the middle age group, as compared to the oldest group. IL-2, IL-4, and IL-22 levels correlated with the severity of CRSwNPs. Elevated concentrations of IL-2, IL-4, and IL-22 were determined in patients’ groups with higher sinonasal outcome test (SNOT-22) scores, pointing to more severe clinical symptoms.

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