Is SNOT-22 a Reliable Tool During Periods of High Stress? A Retrospective Cohort Study

Objective: To assess the impact of a major crisis, such as the October 7, 2023, terror attack, on SNOT-22 scores, especially the extra-rhinologic subdomains. Methods: This retrospective cohort study was conducted at the Rhinology Clinic in a Tertiary University Hospital. Patients who visit our Rhinology Clinic routinely complete the SNOT-22, a widely employed questionnaire designed for evaluating health-related quality of life in individuals with rhinologic conditions. Patients were divided into two groups: 5 weeks before the October 7 terror attack and 5 weeks after. Primary outcomes for analyses included the Sedaghat Subdomain model of the SNOT-22. Descriptive analysis and Welch's t-test were used to compare SNOT-22 subdomain scores between groups. Results: A total of 159 patients completed the SNOT-22 questionnaire, with 60 before and 99 after October 7, 2023. A general decrease in average scores was observed across all subdomains, with a significant decrease in the Nasal subdomain (p = 0.0388). Subgroup analysis showed an increase in the Ear/Facial subdomain in Arabic and the Sleep and Function subdomains in English, though not statistically significant. In sex-based sub-analysis, female patients showed a significant decrease in the Emotions subdomain. Conclusion: Our study was unable to establish a direct link between the terror attack and specific SNOT-22 subdomains. However, the observed trends suggest that SNOT-22 may display variability or unreliability when used during periods of high stress. Level of Evidence: III Laryngoscope, 2024.