Evaluation Scales and Staging Systems

Several evaluation scales currently exist for patients with chronic rhinosinusitis.3 For subjective evaluation there are general health status instruments, such as the Medical Outcomes Study Short Form-36 (SF-36), as well as disease-specific instruments such as the Chronic Sinusitis Survey (CSS), the Rhinosinusitis Outcome Measure (RSOM-31)/Sinonasal Outcome Test (SNOT-20), and the Rhinosinusitis Disability Index (RSDI). Arecently released comprehensive tool for the subjective evaluation of chronic rhinosinusitis is the Chronic Sinusitis TyPE Specific Questionnaire, published by the Health Outcomes Institute.

Objective staging systems for rhinosinusitis also exist. Although an ideal and widely accepted staging scale remains elusive, two staging systems have achieved reasonable accep tance and utility. Kennedy's1 detailed analysis of a patient cohort permitted the proposal of a rational staging system that incorporated surgical findings and radiological appearance and this system has been shown to be predictive of outcome. The more recently proposed Lund-MacKay4'5 system also uses radiologic findings as its primary determinant and was recently recommended by the Rhinosinusitis Task Force6 for validation in large clinical studies because of its ease of use and high degree of inter- and intra-observer agreement.

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