Sinus symptom scores: what is the range in healthy individuals?

Patient symptom severity is an important outcome measure in the assessment and staging of chronic rhinosinusitis. Symptom scores based on a visual analogue scale (VAS) are being used increasingly for this purpose although little, if any, information is available on normal values for these scores. We assessed symptom score ratings using the ICSD symptom scores system (maximum score = 60), in a group of 100 healthy individuals who considered themselves free of nasal conditions. Scores from this healthy sample were compared with scores from a hundred patients suffering from chronic rhinosinusitis. The healthy group did not have a uniformly perfect score (mean = 8.8) and smokers had higher sinus symptom scores than non-smokers (P = 0.02). There was a significant difference in mean values between the healthy sample and the patients with rhinosinusitis (abnormal mean score = 35.3, P = < 0.001). Despite the score difference, a marked overlap existed between the two groups. It should not be assumed that rhinology patients will achieve a zero or near zero score following treatment, but rather their scores should be expected to move closer to the score range for the healthy population.