Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Association Between Subjective Symptom Severity and Radiologic Involvement in CRSwNP Patients Using SNOT-22 and Lund-Mackay Scores

Articles in Press

Document Type : Original

Authors
Sahar Fereydouni 1
Farahzad Jabbari-Azad 1
Maryam Khoshkhui 1
Yaser Yadegari 2
Mehdi Bakhshaee 3
Gohar Shahmirzadi 2
Hassan Mehrad-Majd 4
1 Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
3 Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Cancer Molecular Pathology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/ijorl.2026.93267.4099
Abstract
Abstract

Introduction:

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a subtype of chronic rhinosinusitis characterized by persistent sinonasal symptoms and significant impact on quality of life. Although both subjective and objective assessment tools are widely used, the relationship between patient-reported symptom severity and radiologic findings remains unclear.

Materials and Methods:

In this cross-sectional study, 141 patients diagnosed with CRSwNP were enrolled at Qaem Hospital, Mashhad, Iran, between 2024 and 2025. Symptom severity was assessed using the validated Persian version of the Sinonasal Outcome Test-22 (SNOT-22), and radiologic severity was evaluated using the Lund-Mackay CT scoring system. The correlation between SNOT-22 and CT scores was analyzed using Spearman’s correlation coefficient.

Results:

The mean SNOT-22 score was 51.00 ± 17.86 and the mean Lund-Mackay score was 17.71 ± 4.76. A moderate positive correlation was observed between SNOT-22 and CT scores (r = 0.347, p < 0.001). Patients with asthma or Samter’s triad (n = 70) had significantly higher SNOT-22 and Lund-Mackay scores than those without (p < 0.001).

Conclusion:

There is a moderate correlation between patient-reported symptom severity and objective radiologic findings in CRSwNP. The presence of asthma or Samter’s triad is associated with greater disease burden. Combining subjective symptom assessment with objective radiologic evaluation is important for comprehensive disease management and personalized treatment planning.
Keywords
CRSwNP
SNOT22
Lund-Mackay CT scoring
symptom correlation
CT finding
Subjects
Iranian Journal of Otorhinolaryngology

Articles in Press, Corrected Proof
Available Online from 01 July 2026