Comparison of SNOT-25 and ENS6Q in evaluating patients with empty nose syndrome.

Objectives: Patients with empty nose syndrome (ENS) experience paradoxical nasal obstruction and various psychological burdens. This study aimed to compare ENS-specific questionnaires of sino-nasal outcome test-25 (SNOT-25) and empty nose syndrome 6-item questionnaire (ENS6Q) in the peri-operative evaluation of ENS.

Methods: This was a prospective case series study. Patients with ENS were recruited and evaluated with the SNOT-25, ENS6Q, beck depression inventory-II (BDI-II), and beck anxiety inventory (BAI) before and 6 months after nasal reconstruction surgery.

Results: Seventy-four ENS patients were enrolled during the study period. All four evaluations revealed significant improvements after surgery. Pre-operative SNOT-25 scores exhibited a significant correlation with pre-operative ENS6Q ( = 0.682), BDI-II ( = 0.485), and BAI scores ( = 0.608) ( < 0.001), as well as a weak correlation with post-operative SNOT-25 ( = 0.336), BDI-II ( = 0.266), and BAI scores ( = 0.235) ( < 0.05). Additionally, pre-operative ENS6Q scores were significantly correlated with pre-operative BDI-II ( = 0.434), BAI ( = 0.521) ( < 0.001), and post-operative ENS6Q scores ( = 0.262,  < 0.05). However, there was no correlation between pre-operative ENS6Q scores and post-operative BDI-II and BAI scores.

Conclusions: Both SNOT-25 and ENS6Q were helpful in evaluating peri-operative symptoms for patients with ENS. Although the ENS6Q score had a good correlation with the BDI-II and BAI scores preoperatively, it was not associated with post-operative BDI-II and BAI scores. Hence, a simultaneous psychological assessment is necessary when evaluating patients using the ENS6Q.Level of Evidence: 2c.