ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Systemic predictors of symptom burden in CRSsNP: a cross-sectional comparison of three patient-reported outcome measures.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo examine the influence of sociodemographic and clinical variables on symptom burden in chronic rhinosinusitis without nasal polyps (CRSsNP), and to compare the sensitivity of three validated patient-reported outcome measures (PROMs)-NOSE-E, SNOT-22, and CRS-PRO-to these predictors. A planned sensitivity analysis was conducted to evaluate whether sleep-related item content influences associations with obstructive sleep apnea (OSA). STUDY
designCross-sectional analytical study.
settingTertiary care hospital.
methodsFifty adults with CRSsNP completed the NOSE-E, SNOT-22, and CRS-PRO questionnaires. Sociodemographic and clinical variables, including age, sex, BMI, smoking status, allergic rhinitis, asthma, OSA, and prior nasal surgery, were recorded. Univariate and multivariable linear regressions were used to identify independent predictors for each PROM. A predefined sleep-free analysis excluded sleep- and fatigue-related items (NOSE-E item 4; SNOT-22 items 11-14; CRS-PRO items 9-10).
resultsEach PROM demonstrated a distinct predictor profile. In multivariable models, age and smoking independently predicted NOSE-E scores. Previous nasal surgery was the only independent predictor of SNOT-22 scores. Age and OSA were associated with CRS-PRO scores in the primary model; however, the OSA association disappeared in the sleep-free analysis, indicating that it was driven by sleep-related item content rather than sinonasal symptomatology. All models showed modest explanatory capacity (adjusted R² ≈ 0.10-0.19).
conclusionSystemic and lifestyle factors exert instrument-specific influences on symptom reporting in CRSsNP. The apparent association between OSA and CRS-PRO is mediated by sleep-related items, underscoring the importance of considering domain structure when selecting and interpreting PROMs. PROM-based evaluations in CRSsNP should incorporate domain-aware interpretation and caution in patients with sleep comorbidities.
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