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Published on: October 16, 2013
Comparison of different endoscopic scoring systems in patients with chronic rhinosinusitis: reliability, validity,
Objectives:
Previous studies have proposed various endoscopic scoring systems to assess disease severity of patients with chronic rhinosinusitis (CRS). However, those assessments have not been validated. This study was designed to assess the Modified Lund - Kennedy (MLK) and the discharge, inflammation, and polyps/oedema (DIP) endoscopic scoring systems in patients with CRS.
Methods:
A prospective study including 144 patients who underwent functional endoscopic sinus surgery (FESS). All participants were asked to finish SNOT-22, Lund-Mackay CT score and endoscopic examination evaluations before surgery and at 6 months after surgery. Endoscopic examination videos were evaluated using 3 scoring systems by two blinded rhinologists. The scores were compared in terms of responsiveness, validity, reliability and correlation with other scores.
Results:
The MLK and DIP endoscopic scoring systems showed high test-retest reliability and inter-rater reliability. All endoscopic scoring systems showed significant differences between the scores recorded at each time point (all P lower than 0.90 when compared with the Lund - Kennedy (LK) endoscopic scoring system and showed a statistically significant difference in discriminant validity between symptomless and symptomatic cases. The MLK and DIP systems showed high correlations with other subject assessments and no correlation with SNOT-22.
Conclusion:
MLK and DIP exhibit substantial responsiveness, validity and reliability. MLK and DIP may be well suited for clinical and research use.

