Preoperative Lund‐Mackay computed tomography score is associated with preoperative symptom severity and predicts quality‐of‐life outcome trajectories after sinus surgery

Brooks, S.C.; Trope, Michal; Blasetti, Mariel; Doghramji, Laurel; Parasher, Arjun K.; Glicksman, Jordan T.; Kennedy, David W.; Thaler, Erica R.; Cohen, Noam A.; Palmer, James N.; Adappa, Nithin D.

doi:10.1002/alr.22109

Cited by 75 publications

(70 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most previous studies exploring the correlation between the SNOT-22 total score and the Lund–Mackay score have concluded that there is only little correlation [ 15 , 16 ]. However, similar to the present study, Brooks and colleagues observed a significant association between preoperative and postoperative SNOT-22 total scores (both p < 0.01) driven by the “ nasal symptoms ” domain [ 13 ]. In accordance with Sedaghat and co-workers, moreover, a significant correlation was found between the “ nasal symptoms ” domain and the Lund–Mackay score [ 24 ].…”

Section: Discussionsupporting

confidence: 87%

The SNOT-22 factorial structure in European patients with chronic rhinosinusitis: new clinical insights

Dejaco

Riedl

Huber

et al. 2019

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Purpose The sino-nasal outcomes test-22 (SNOT-22) represents the reference questionnaire to assess patients with chronic rhinosinusitis (CRS). As weak correlations between objective CRS parameters and SNOT-22 total score have been observed, factor analyses have aimed to identify underlying factorial structures. However, ambiguous factor loadings and problematic item-domain assignments have resulted. Moreover, such factor analyses have mainly been performed in non-European CRS patients, while European data remain sparse. This study thus sought to address these issues. Methods Principal component analysis and confirmatory factor analysis were performed from SNOT-22 questionnaires completed by European CRS patients. Goodness of fit, internal consistencies, and factor loadings were calculated. Item-domain assignment was based on statistical grounds and clinical meaningfulness. Additionally, this study investigated correlations between SNOT-22 domains and external reference criteria, including Lund–Mackay score, Lund–Naclerio score and the brief symptom inventory 18 (BSI-18). Results One hundred and thirty-four European CRS patients were included. Principal component analysis proposed four SNOT-22 domains (“ nasal symptoms ”, “ otologic symptoms ”, “ sleep symptoms ”, “ emotional symptoms ”), which explained 63.6% of variance. Observed item-domain-assignment differed from previously proposed item-domain assignments. All factor loadings were > 0.5, except “cough” (0.42) and “facial pain or pressure” (0.49). For confirmatory factor analysis, satisfactory goodness of fit (RMSEA = 0.66; CFI = 0.92; TLI = 0.90) and internal consistencies (Cronbach-α: total score = 0.93; domains = 0.75–0.91) were observed. Significant positive correlations were found between the “ nasal symptoms ” domain and both the Lund–Mackay score ( r = 0.48; p < 0.001) and the Lund–Naclerio score ( r = 0.27, p < 0.01). Significant positive correlations were also identified between “ emotional symptoms ” and BSI-18 total score ( r = 0.64, p < 0.001). Conclusions Principal component analysis performed for SNOT-22 questionnaires completed by European CRS patients indicated a different item-domain-assignment than previously reported. Confirmatory factor analysis suggested acceptable and clinically plausible psychometric properties for the resulting factorial structure. Significant correlations between the “ nasal symptoms ” and the “ emotional symptoms ” domains were observed with objective CRS parameters. The resulting factorial structure with different item-domain assignments may ...

show abstract

Section: Discussionsupporting

confidence: 87%

The SNOT-22 factorial structure in European patients with chronic rhinosinusitis: new clinical insights

Dejaco

Riedl

Huber

et al. 2019

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

show abstract

“…However, truly objective quantification of sinus opacification has been elusive 5 . The well‐known Lund‐Mackay (LM) system 6 provides a simple technique for semiquantitative visual scoring of sinus CT that correlates with clinical measures of disease severity, 7‐9 but does not consistently correlate with symptoms 10 . Visual scoring is also time‐consuming, subjective, and lacks sensitivity to change.…”

mentioning

confidence: 99%

Volumetric assessment of paranasal sinus opacification on computed tomography can be automated using a convolutional neural network

Humphries

Centeno

Notary

et al. 2020

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

Background Computed tomography (CT) plays a key role in evaluation of paranasal sinus inflammation, but improved, and standardized, objective assessment is needed. Computerized volumetric analysis has benefits over visual scoring, but typically relies on manual image segmentation, which is difficult and time‐consuming, limiting practical applicability. We hypothesized that a convolutional neural network (CNN) algorithm could perform automatic, volumetric segmentation of the paranasal sinuses on CT, enabling efficient, objective measurement of sinus opacification. In this study we performed initial clinical testing of a CNN for fully automatic quantitation of paranasal sinus opacification in the diagnostic workup of patients with chronic upper and lower airway disease. Methods Sinus CT scans were collected on 690 patients who underwent imaging as part of multidisciplinary clinical workup at a tertiary care respiratory hospital between April 2016 and November 2017. A CNN was trained to perform automatic segmentation using a subset of CTs (n = 180) that were segmented manually. A nonoverlapping set (n = 510) was used for testing. CNN opacification scores were compared with Lund‐MacKay (LM) visual scores, pulmonary function test results, and other clinical variables using Spearman correlation and linear regression. Results CNN scores were correlated with LM scores (rho = 0.82, p < 0.001) and with forced expiratory volume in 1 second (FEV1) percent predicted (rho = −0.21, p < 0.001), FEV1/forced vital capacity ratio (rho = −0.27, p < 0.001), immunoglobulin E (rho = 0.20, p < 0.001), eosinophil count (rho = 0.28, p < 0.001), and exhaled nitric oxide (rho = 0.40, p < 0.001). Conclusion Segmentation of the paranasal sinuses on CT can be automated using a CNN, providing truly objective, volumetric quantitation of sinonasal inflammation.

show abstract

“…The score also correlated with symptom reduction (coeff=0.24, p=0.02), complication rate (OR 1.08, 95% confidence interval (CI) 1.06-1.1) and revision rates (OR 1.03, 95% CI 1.001-1.06) but showed no correlation with SNOT-22 scores. In contrast, a more recent study (220) showed that the preoperative LMS in 665 patients with medically recalcitrant CRS correlated significantly with preoperative extranasal and rhinologic symptom severity on the SNOT-22 and that the LMS was an indicator of postsurgical QOL outcomes.…”

Section: Discussionmentioning

confidence: 74%

European position paper on diagnostic tools in rhinology

Rimmer

Hellings

Lund

et al. 2019

Rhin

114

View full text Add to dashboard Cite

is the official Journal of the European and International Rhinologic Societies and appears quarterly in March, June, September and December. Cited in Pubmed, Current Contents, Index Medicus, Exerpta Medica and Embase Founded in 1963 by H.A.E. van Dishoeck, Rhinology is a worldwide non-profit making journal. The journal publishes original papers on basic research as well as clinical studies in the major field of rhinology, including physiology, diagnostics, pathology, immunology, medical therapy and surgery of both the nose and paranasal sinuses. Review articles and short communications are also pulished. All papers are peer-reviewed. Letters-to-the-editor provide a forum for comments on published papers, and are not subject to editorial revision except for correction of English language. In-depth studies that are too long to be included into a regular issue can be published as a supplement. Supple ments are not subject to peer-review.

show abstract

Preoperative Lund‐Mackay computed tomography score is associated with preoperative symptom severity and predicts quality‐of‐life outcome trajectories after sinus surgery

Abstract: Our study demonstrates that preoperative LMCTS correlate with preoperative extranasal and rhinologic symptom severity and that the LMCTS is an indicator of postsurgical QoL outcomes for medically recalcitrant chronic rhinosinusitis patients in a large tertiary otolaryngology setting.

Cited by 75 publications

References 28 publications

The SNOT-22 factorial structure in European patients with chronic rhinosinusitis: new clinical insights

The SNOT-22 factorial structure in European patients with chronic rhinosinusitis: new clinical insights

Volumetric assessment of paranasal sinus opacification on computed tomography can be automated using a convolutional neural network

European position paper on diagnostic tools in rhinology

Contact Info

Product

Resources

About