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Sino Nasal Outcome Test

We would like to know more about your Chronic Rhinosinusitis, and appreciate your answering of the following questions to the best of your ability. There are no right or wrong answers, and only you know the answer to these questions. Please rate the problems as they have been over the past 2 weeks. Thank you for your participation.

How severe is your problem when you experience it? Please rate how bad it is choosing the number that corresponds with how you feel using this scale.

Need to blow nose
Nasal Blockage
Sneezing
Running Nose
Cough
Post Nasal Discharge
Thick Nasal Discharge
Decreased Sense of Smell / Taste
Wake up at night
Fatigue
Reduced Productivity
Reduced Concentration
Frustrated / Restless / Irritable
Sad
Embarassed

Total Nasal Symptom Score for symptoms of Allergy-related Disease.

Where...

​0 = No Symptoms

1 = Symptoms present but easily tolerated

2 = Aware of Symptoms, bothersome, but tolerable

3 =  Hard to tolerate and interferes with daily activities

Sneezing
Congestion
Itching
Rhinorrhoea (runny nose)

Over the past month, how much of a problem were the following conditions for you?

Nasal Congestion or stuffiness
Nasal Blockage or Obstruction
Trouble Breathing through my nose
Trouble Sleeping
Unable to get enough air through my nose

Nasal Obstruction severity classificationMild ( 5 - 25 ) Moderate ( 30 - 50 ) Severe ( 55 - 75 ) Extreme ( 80 -100 )

NOSE SCORE (multiply your total score x5):

Click here to download

Contact

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Level 3, Suite 303, BMA House

135 Macquarie St

Sydney CBD 2000

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P: 02 9247 1762

F: 02 9247 2141

email: contact@my-ent.com.au

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Opening Hours

8:30 am - 5:00 pm Monday - Friday

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