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

Fereydouni, Sahar; Jabbari-Azad, Farahzad; Khoshkhui, Maryam; Yadegari, Yaser; Bakhshaee, Mehdi; Shahmirzadi, Gohar; Mehrad-Majd, Hassan

doi:10.22038/ijorl.2026.93267.4099

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

Document Type : Original

Authors

Sahar Fereydouni ¹

Farahzad Jabbari-Azad ¹

Maryam Khoshkhui ¹

Yaser Yadegari ¹

Mehdi Bakhshaee ²

Gohar Shahmirzadi ¹

Hassan Mehrad-Majd ³

¹ Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

² Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

³ Clinical Research Development Unit, Ghaem Hospital, Faculty of Medicine, 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