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Prevalence and Correlates of Sinonasal Symptom Burden in Young Adult Males: A Cross-Sectional Population-Based Study
Emanuel Maitz1, Reinhard Domanyi1,2, Gerold Schwantzer3
1Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, 8010 Graz, Austria.
Objectives:
Chronic rhinosinusitis (CRS) is a prevalent chronic inflammatory upper airway disease. Despite a higher radiological disease burden in males, clinical CRS diagnoses are disproportionately registered in females, suggesting systematic underdiagnosis in young men. The 22-item Sinonasal Outcome Test (SNOT-22) represents the reference patient-reported outcome measure (PROM) for sinonasal symptom burden. This study aimed to determine the prevalence of sinonasal symptom burden and to identify associated clinical, laboratory, and lifestyle parameters in a large cohort of young male adults.
Methods:
In this prospective cross-sectional study, 500 young male adults underwent, as part of the conscription examination, standardized assessment including the SNOT-22, spirometry (FEV1%), whole blood count (eosinophils), and serum CRP. SNOT-22 scores were categorized as none (0-20), moderate (21-50), and severe (>50). Associations were analyzed using Spearman correlation, Mann-Whitney U, and Chi2 tests.
Results:
The mean SNOT-22 score was 18.8 (SD 15.2; range 0-73). A total of 38.2% of participants scored ≥21, indicating at least moderate sinonasal symptom burden. SNOT-22 correlated significantly with CRP (r = 0.117, p = 0.009) and inversely with relative FEV1% (r = -0.103, p = 0.022). Eosinophils showed a numeric gradient across SNOT-22 categories (3.08% vs. 3.31% vs. 3.56%) without reaching significance.
Conclusions:
More than one third of young male adults reported significant self-reported sinonasal symptom burden. Symptom severity was associated with systemic inflammatory markers and reduced pulmonary function, supporting the unified airway concept. These findings support the utility of SNOT-22 as a low-threshold assessment tool for self-reported sinonasal symptom burden in preventive health examinations.