PMID- 28349563
OWN - NLM
STAT- MEDLINE
DCOM- 20170828
LR  - 20191210
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Linking)
VI  - 127
IP  - 8
DP  - 2017 Aug
TI  - Defining surgical criteria for empty nose syndrome: Validation of the 
      office-based cotton test and clinical interpretability of the validated Empty 
      Nose Syndrome 6-Item Questionnaire.
PG  - 1746-1752
LID - 10.1002/lary.26549 [doi]
AB  - OBJECTIVES/HYPOTHESIS: The validated Empty Nose Syndrome 6-Item Questionnaire 
      (ENS6Q) identifies empty nose syndrome (ENS) patients. The unvalidated cotton 
      test assesses improvement in ENS-related symptoms. By first validating the cotton 
      test using the ENS6Q, we define the minimal clinically important difference 
      (MCID) score for the ENS6Q. STUDY DESIGN: Individual case-control study. METHODS: 
      Fifteen patients diagnosed with ENS and 18 controls with non-ENS sinonasal 
      conditions underwent office cotton placement. Both groups completed ENS6Q testing 
      in three conditions-precotton, cotton in situ, and postcotton-to measure the 
      reproducibility of ENS6Q scoring. Participants also completed a five-item 
      transition scale ranging from "much better" to "much worse" to rate subjective 
      changes in nasal breathing with and without cotton placement. Mean changes for 
      each transition point, and the ENS6Q MCID, were then calculated. RESULTS: In the 
      precotton condition, significant differences (P < .001) in all ENS6Q questions 
      between ENS and controls were noted. With cotton in situ, nearly all prior ENS6Q 
      differences normalized between ENS and control patients. For ENS patients, the 
      changes in the mean differences between the precotton and cotton in situ 
      conditions compared to postcotton versus cotton in situ conditions were 
      insignificant among individuals. Including all 33 participants, the mean change 
      in the ENS6Q between the parameters "a little better" and "about the same" was 
      4.25 (standard deviation [SD] = 5.79) and -2.00 (SD = 3.70), giving an MCID of 
      6.25. CONCLUSIONS: Cotton testing is a validated office test to assess for ENS 
      patients. Cotton testing also helped to determine the MCID of the ENS6Q, which is 
      a 7-point change from the baseline ENS6Q score. LEVEL OF EVIDENCE: 3b. 
      Laryngoscope, 127:1746-1752, 2017.
CI  - (c) 2017 The American Laryngological, Rhinological and Otological Society, Inc.
FAU - Thamboo, Andrew
AU  - Thamboo A
AD  - Division of Rhinology, Department of Otolaryngology-Head and Neck Surgery, 
      Stanford University School of Medicine, Palo Alto, California, U.S.A.
FAU - Velasquez, Nathalia
AU  - Velasquez N
AD  - Division of Rhinology, Department of Otolaryngology-Head and Neck Surgery, 
      Stanford University School of Medicine, Palo Alto, California, U.S.A.
AD  - Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, 
      Pittsburgh, Pennsylvania, U.S.A.
FAU - Habib, Al-Rahim R
AU  - Habib AR
AD  - Sydney Medical Program, University of Sydney, Sydney, New South Wales, Australia.
FAU - Zarabanda, David
AU  - Zarabanda D
AD  - Division of Rhinology, Department of Otolaryngology-Head and Neck Surgery, 
      Stanford University School of Medicine, Palo Alto, California, U.S.A.
FAU - Paknezhad, Hassan
AU  - Paknezhad H
AD  - Division of Rhinology, Department of Otolaryngology-Head and Neck Surgery, 
      Stanford University School of Medicine, Palo Alto, California, U.S.A.
FAU - Nayak, Jayakar V
AU  - Nayak JV
AD  - Division of Rhinology, Department of Otolaryngology-Head and Neck Surgery, 
      Stanford University School of Medicine, Palo Alto, California, U.S.A.
LA  - eng
PT  - Journal Article
PT  - Validation Study
DEP - 20170327
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Adult
MH  - Clinical Decision-Making
MH  - Cotton Fiber
MH  - *Diagnostic Self Evaluation
MH  - Diagnostic Techniques, Respiratory System
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nose Diseases/*diagnosis/*surgery
MH  - *Office Visits
MH  - Prospective Studies
MH  - Syndrome
OTO - NOTNLM
OT  - ENS6Q
OT  - Empty nose syndrome
OT  - clinical interpretability
OT  - cotton pledget
OT  - cotton test
OT  - minimal clinically important difference
OT  - paradoxical nasal obstruction
OT  - questionnaire
OT  - survey
EDAT- 2017/03/30 06:00
MHDA- 2017/08/29 06:00
CRDT- 2017/03/29 06:00
PHST- 2016/10/05 00:00 [received]
PHST- 2017/01/15 00:00 [revised]
PHST- 2017/01/27 00:00 [accepted]
PHST- 2017/03/30 06:00 [pubmed]
PHST- 2017/08/29 06:00 [medline]
PHST- 2017/03/29 06:00 [entrez]
AID - 10.1002/lary.26549 [doi]
PST - ppublish
SO  - Laryngoscope. 2017 Aug;127(8):1746-1752. doi: 10.1002/lary.26549. Epub 2017 Mar 
      27.