Association Between Subjective Symptom Severity and Radiologic Involvement in CRSwNP Patients Using SNOT-22 and Lund-Mackay Scores.

INTRODUCTION: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory sinonasal disorder associated with persistent symptoms and considerable impairment in quality of life. While both subjective symptom scores and objective radiologic assessments are commonly used in clinical practice, the association between these two measures has not been fully established. MATERIALS AND METHODS: This cross-sectional study included 141 patients with confirmed CRSwNP who were recruited from Qaem Hospital, Mashhad, Iran, during 2024-2025. Symptom burden was evaluated using the validated Persian version of the Sinonasal Outcome Test-22 (SNOT-22), whereas radiologic disease extent was assessed using the Lund-Mackay computed tomography scoring system. The relationship between SNOT-22 and CT scores was examined using Spearman's correlation analysis. RESULTS: The mean SNOT-22 score was 51.00 ± 17.86, while the mean Lund-Mackay score was 17.71 ± 4.76. Analysis demonstrated a moderate positive correlation between SNOT-22 and CT scores (r = 0.347, p < 0.001). Patients with asthma or Samter's triad (n = 70) showed significantly higher SNOT-22 and Lund-Mackay scores compared with those without these comorbidities (p < 0.001). CONCLUSION: A moderate association was identified between symptom severity reported by patients and radiologic disease severity in CRSwNP. Coexisting asthma or Samter's triad was linked to a greater overall disease burden. These findings highlight the value of integrating subjective symptom scoring with objective radiologic assessment for more comprehensive evaluation and individualized management.