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Facial Plastic and Reconstructive Surgery

(112) Correlation Between Nasal Function Assessment Scores in Cleft Deformity Patients

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • RS

    Ryan M. Sicard, BS

    Medical Student
    Icahn School of Medicine at Mount Sinai
    New York, New York, United States

    • Co-Author(s)

  • JM

    Jeffrey R. Marcus, MD

    Chief, Division of Plastic, Maxillofacial and Oral Surgery
    Duke University, Department of Surgery
    Durham, NC, USA

  • DF

    Dennis O. Frank-Ito, PhD

    Associate Professor
    Duke University, Department of Head and Neck Surgery and Communication Sciences
    Durham, NC, USA

    • Senior Author(s)

  • DF

    Dennis O. Frank-Ito, PhD

    Associate Professor
    Duke University, Department of Head and Neck Surgery and Communication Sciences
    Durham, NC, USA

Disclosure(s):
Ryan M. Sicard, BS: No relevant relationships to disclose.


Introduction: NOSE and SCHNOS are patient-reported questionnaires that assess patients’ subjective perceptions of their nasal function. This study identifies the correlation between the two scores in cleft patients pre- and post-repair surgery.

Methods: Nine cleft deformity subjects received surgical repair between Nov. 2019 and Dec. 2022. Patients filled out NOSE and SCHNOS questionnaires pre-operatively and at 4 visits post-operatively. The NOSE (scale 0-5) score consists of 5 questions about nasal congestion, difficulty breathing, trouble sleeping, air hunger sensation, and blockage. The SCHNOS Obstruction domain (scale 0-5) consists of nasal blockage, congestion, difficulty breathing through nose during exercise and during sleep. Each sub-score was converted to an overall score which were then compared across visits.

Results: Of the 6 patients with follow-up visits, 2 had a clinically significant improvement in NOSE score while 3 showed improvement in SCHNOS-O. The average of the absolute difference between NOSE and SCHNOS-O scores for the same visit was 17. Intra-patient, same-visit score variations ranged from 8 to 45 with a median of 15. Variation was generally lower in patients who returned for more visits. Trends across visits were generally consistent in terms of directionality between NOSE and SCHNOS-O scores with differences typically 5 or less. NOSE and SCHNOS-O have 3 identical categories: congestion, blockage/obstruction, and air flow during exercise. In 24% of the observations, NOSE and SCHNOS-O sub-scores of the same category varied by more than 1 point or had the patient report no problem in one survey and some degree of problem in the other.

Conclusions: While both questionnaires showed the same trends across visits, there was substantial difference in overall score between the two surveys. Additionally, in around one-quarter of instances where the same question was asked by both questionnaires, patients responded inconsistently.