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Cited by 204Nasal Surgery and Airway StudiesSinusitis and nasal conditionsObstructive Sleep Apnea Research

A Systematic Review of Patient-Reported Nasal Obstruction Scores: Defining Normative and Symptomatic Ranges in Surgical Patients

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Rhee, John S., Sullivan, Corbin D., Frank, Dennis O., Kimbell, Julia S., Garcia, Guilherme J. M.·2014·JAMA Facial Plastic Surgery
DOI 10.1001/jamafacial.2013.2473PMC PMC4072745
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Abstract

IMPORTANCE A gold standard objective measure of nasal airway obstruction (NAO) does not currently exist, so patient-reported measures are commonly used, particularly the Nasal Obstruction Symptom Evaluation (NOSE) scale and the visual analog scale (VAS). However, questions remain regarding how best to use these instruments. OBJECTIVES To systematically review studies on NOSE and VAS scores in patients with NAO and to compile and standardize the data to (1) define symptomatic and normative values for presurgical and postsurgical patients with NAO, asymptomatic individuals, and the general population; (2) determine if postsurgical scores are comparable with asymptomatic scores; and (3) determine if there is a clinically useful preoperative and postoperative score change. EVIDENCE REVIEW A systematic review of the literature was performed through PubMed for studies assessing NOSE and VAS scores in patients with chronic NAO. Strict inclusion criteria were applied to focus on anatomic obstruction only. For statistical analysis, the patients were classified as asymptomatic, presurgical and postsurgical with NAO, and the general population. FINDINGS The mean (SD) NOSE and VAS scores for a patient with NAO were 65 (22) and 6.9 (2.3), respectively. The mean postsurgical NOSE and VAS scores were 23 (20) and 2.1 (2.2), respectively. The mean asymptomatic individual NOSE and VAS scores were 15 (17) and 2.1 (1.6). The mean NOSE and VAS scores for the general population were 42 (27) and 4.6 (2.6), respectively. The mean presurgical to postsurgical change was more than 40 for NOSE scores and more than 4.0 for VAS scores. CONCLUSIONS AND RELEVANCE We have shown that normative and abnormal value ranges for NOSE and VAS can be established for clinical use. Given the consistency of both scales, we conclude that these measures can be used as a clinically meaningful measure of successful surgical outcomes.

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  • In asymptomatic individuals, the mean visual analog scale value used to assess nasal obstruction ranges from 2.1 (2.2) to 4.6 (2.6) in the general population.

    “It has been estimated that, in asymptomatic individuals, the mean VAS value used to assess NO ranges from 2.1 (2.2) to 4.6 (2.6) in the general population [23].”

    From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [23]

    The Results (VAS scores) report 4.6 ± 2.6 for the general population, but 2.1 ± 1.6 for asymptomatic individuals—not 2.1 ± 2.2. The latter figure is the post-surgery mean, and the paper treats asymptomatic individuals and the general population as distinct groups rather than a single population with a range of means. (LLM, conf=0.92)

    Experimental — accuracy not yet measured

  • The NOSE questionnaire yields a mean value of 15 (17) in the asymptomatic individual and 42 (27) in the general population.

    “It has been estimated that the NOSE questionnaire yields a mean value of 15 (17) in the asymptomatic individual and 42 (27) in the general population [23].”

    From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [23]

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References 39 · Cited by 204

Research works printed but not linked: 34

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Authors
Rhee, J. S., Sullivan, C. D., Frank, D. O., Kimbell, J. S., & Garcia, G. J. M.
Affiliations
  • Medical College of Wisconsin (US)
  • Department of Otolaryngology–Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill
  • University of North Carolina at Chapel Hill (US)
Corresponding author
Sullivan, Corbin D.
ORCID
Venue
JAMA Facial Plastic Surgery
Publisher
SAGE Publications
Published
2014-05
Volume
16
Issue
3
Pages
219-225
ISSN
  • 2168-6076 (ISSN-L)
  • 2168-6092
DOI
10.1001/jamafacial.2013.2473
PMC
PMC4072745
OpenAlex
W2141066741
Cited by
204
References
39
Citations by year
2026: 11 · 2025: 9 · 2024: 18 · 2023: 16 · 2022: 13 · 2021: 17 · 2020: 31 · 2019: 22 · 2018: 18 · 2017: 25 · 2016: 14 · 2015: 10
FWCI
3.08
Type
journal article
Language
en
Open access
Licence
www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/ (tdm)
Locations
  • JAMA Facial Plastic Surgery (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Biomedical Imaging and Bioengineering (R01EB009557)
Topics
  • Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
  • Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
Keywords
nasal obstruction, patient-reported outcome measures, Nasal Obstruction Symptom Evaluation, visual analogue scale, reference values, nasal surgery outcomes
MeSH terms
Humans, Pain Measurement, Rhinoplasty, Nasal Obstruction, Treatment Outcome, Self Report

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