Diagnostic accuracy of sino?nasal outcome test?22 and lund?kennedy endoscopic score for chronic rhinosinusitis in pre bone marrow transplantation assessment

Abstract

Background: The diagnosis of chronic rhinosinusitis (CRS) is a crucial and challenging entity in bone marrow transplantation candidates. We aimed to evaluate the  diagnostic accuracy of the Sino?Nasal Outcome Test (SNOT?22) and Lund?Kennedy endoscopic score for the diagnosis of CRS in bone marrow transplantation candidates.

Materials and Methods: We conducted a single?center, observational study evaluating bone marrow transplantation candidates by paranasal sinus computed tomography (CT) scan without contrast to measure the Lund Mackay score. Patients with a Lund Mackay score higher than or equal to four or with any evidence of sino?nasal fungus ball in their paranasal sinus CT were considered CRS. The Lund Kennedy endoscopic score and SNOT?22 were also calculated for all participants.

Results: This study included 495 patients, of which 63 were diagnosed with CRS. Participants had a median age of 40 (30, 57) years old and 51.3% were male. The Lund Kennedy score and SNOT?22 were correlated with the Lund Mackay score. Furthermore, both SNOT?22 and Lund Kennedy scores were the predictors of CRS based on univariate logistic regression (odds ratio [95% confidence interval (CI)]: 1.10 [1.06, 1.15], 1.37 [1.22, 1.56], respectively). Lund Kennedy score ?1 had a
sensitivity of 0.78 (95% CI: 0.66, 0.87) and a specificity of 0.76 (95% CI: 0.52, 0.83) (AUC [95% CI]: 0.81 [0.75, 0.87]), while SNOT?22 did not yield a remarkable diagnostic accuracy.

Conclusion: The Lund?Kennedy endoscopy score could diagnose CRS in bone marrow
transplantation candidates with satisfactory accuracy, whereas SNOT?22 lacks enough accuracy to be employed as an independent sino?nasal assessment modality in these patients.