Skip to content
MedikQuantis
Informational · does not replace consultation with a healthcare professional.

Sinonasal Outcome Test (SNOT-22)

22-item questionnaire measuring the impact of chronic rhinosinusitis symptoms on quality of life.

Switch how results are explained

Need to blow your nose
Nasal blockage
Sneezing
Runny nose
Cough
Post-nasal discharge
Thick nasal discharge
Ear fullness
Dizziness
Ear pain
Facial pain or pressure
Loss of sense of smell or taste
Difficulty falling asleep
Waking up at night
Lack of a good night's sleep
Waking up tired
Fatigue during the day
Reduced productivity
Reduced concentration
Feeling frustrated, restless or irritable
Feeling sad
Feeling embarrassed
Score0low risk
low riskmoderate riskhigh risk

Mild sinonasal symptom burden (0-20). Limited impact on daily life on this basis alone.

Evidence grade
B

What it is and when to use it

SNOT-22 scores 22 sinonasal, otologic, sleep and emotional symptoms by their impact over the past 15 days, from 0 (no problem) to 5 (as bad as it can be). The sum of the 22 items gives a score from 0 to 110.

How to interpret it

0–20 mild; 21–50 moderate; 51–110 severe (Toma and Hopkins, 2016). The absolute score indicates baseline severity, but the minimal clinically important difference is 8.9 points: a change of this magnitude between two administrations is what is considered clinically meaningful — for example after treatment or surgery — more so than any single absolute total.

Limitations and when not to use it

This is a self-administered questionnaire reflecting the patient's subjective perception over the preceding 15 days; it does not replace nasal endoscopy or imaging. The otologic and emotional items are not specific to sinonasal disease and may be influenced by comorbidities.

Formulas and cut-offs are from the original authors of each score; see the references.

Last reviewed: June 2026

References
  1. Hopkins C, Gillett S, Slack R, Lund VJ, Browne JP. Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol. 2009;34(5):447-454. PMID:19793277
  2. Toma S, Hopkins C. Stratification of SNOT-22 scores into mild, moderate or severe and relationship with other subjective instruments. Rhinology. 2016;54(2):129-133. PMID:27017484