%0 Journal Article %T SNOT-22 subdomain outcomes following treatment for sinonasal malignancy: A prospective, multicenter study. %A Grimm DR %A Beswick DM %A Maoz SL %A Wang EW %A Choby GW %A Kuan EC %A Chan EP %A Adappa ND %A Geltzeiler M %A Getz AE %A Humphreys IM %A Le CH %A Abuzeid WM %A Chang EH %A Jafari A %A Kingdom TT %A Kohanski MA %A Lee JK %A Nayak JV %A Palmer JN %A Patel ZM %A Pinheiro-Neto CD %A Resnick AC %A Sim MS %A Smith TL %A Snyderman CH %A John MA %A Storm P %A Suh JD %A Wang MB %A Hwang PH %J Int Forum Allergy Rhinol %V 14 %N 8 %D 2024 Aug 19 %M 38372441 %F 5.426 %R 10.1002/alr.23338 %X BACKGROUND: Patients with sinonasal malignancy (SNM) present with significant sinonasal quality of life (QOL) impairment. Global sinonasal QOL as measured by the 22-item Sinonasal Outcomes Test (SNOT-22) has been shown to improve with treatment. This study aims to characterize SNOT-22 subdomain outcomes in SNM.
METHODS: Patients diagnosed with SNM were prospectively enrolled in a multi-center patient registry. SNOT-22 scores were collected at the time of diagnosis and through the post-treatment period for up to 5 years. Multivariable regression analysis was used to identify drivers of variation in SNOT-22 subdomains.
RESULTS: Note that 234 patients were reviewed, with a mean follow-up of 22 months (3 months-64 months). Rhinologic, psychological, and sleep subdomains significantly improved versus baseline (all p < 0.05). Subanalysis of 40 patients with follow-up at all timepoints showed statistically significant improvement in rhinologic, extra-nasal, psychological, and sleep subdomains, with minimal clinically important difference met between 2 and 5 years in sleep and psychological subdomains. Adjuvant chemoradiation was associated with worse outcomes in rhinologic (adjusted odds ratio (5.22 [1.69-8.66])), extra-nasal (2.21 [0.22-4.17]) and ear/facial (5.53 [2.10-8.91]) subdomains. Pterygopalatine fossa involvement was associated with worse outcomes in rhinologic (3.22 [0.54-5.93]) and ear/facial (2.97 [0.32-5.65]) subdomains. Positive margins (5.74 [2.17-9.29]) and surgical approach-combined versus endoscopic (3.41 [0.78-6.05])-were associated with worse psychological outcomes. Adjuvant radiation (2.28 [0.18-4.40]) was associated with worse sleep outcomes.
CONCLUSIONS: Sinonasal QOL improvements associated with treatment of SNM are driven by rhinologic, extra-nasal, psychological, and sleep subdomains.