Normal aging does not deteriorate nose-related quality of life: Assessment with ‘‘NOSE’’ and ‘‘SNOT-20’’ questionnaires Joerg Lindemann a , Evangelia Tsakiropoulou b, * , Iordanis Konstantinidis b , Kerstin Lindemann a a Department of Otorhinolaryngology, University of Ulm, Ulm, Germany b 2nd Department of Otorhinolaryngology, Aristotle University of Thessaloniki, Thessaloniki, Greece Received 22 June 2009; accepted 14 September 2009 Available online 10 November 2009 Abstract Objective: Aging causes changes in nasal morphology and function. This study assesses if the age-related nasal changes are detectable with objective measurements and reflected in two validated quality of life outcome tools: the Nasal Obstruction Symptom Evaluation Scale (NOSE) and the Sino-Nasal Outcome Test (SNOT-20) questionnaires. Methods: Two study groups were included: the ‘‘young’’ group A (n = 40) with a mean age of 27 years and the ‘‘elder’’ group B (n = 40) with a mean age of 70 years. The subjective nasal complaints and quality of life status were recorded by means of the NOSE and SNOT-20 questionnaires. Objective assessment of intranasal dimensions and nasal airflow in all subjects were performed with the use of acoustic rhinometry and active anterior rhinomanometry respectively. Results: The values obtained from acoustic rhinometry were significantly higher in the older group compared to the younger, presenting wider nasal airway passages for the elderly. However this was not the case with rhinomanometry values as no significant differences between groups were found. In addition no statistically significant difference was demonstrated in both questionnaires scoring between younger and older subjects. Conclusion: The outcome of the NOSE and SNOT questionnaires show no deterioration of quality of life in elderly related with changes in nasal function. Acoustic rhinometry confirmed that nasal cavities are becoming larger across the lifespan. # 2009 Elsevier Ireland Ltd. All rights reserved. Keywords: Aging nose; NOSE; SNOT-20; Nasal obstruction; Acoustic rhinometry; Rhinomanometry; Quality of life 1. Introduction A number of age-related changes in the nose are causing alterations in both nasal physiology and anatomy. These changes affect all of its structural components, including skin, muscles, cartilages, mucosa and bones. The changes in the nasal cartilages are the most important in shaping the aged nose with consequences like a dropped nasal tip. Functionally reduced intranasal air conditioning capacity and enlargement of nasal cavities due to involution atrophy of the nasal mucosa have been reported [1]. Assessment of nasal patency should include objective examinations like imaging, nasal endoscopy, acoustic rhinometry or active anterior rhinomanometry combined with outcome instruments in order to evaluate the subjective severity of symptoms. Although there are numerous validated instruments measuring the health status and quality of life of patients, there is a lack of data regarding nasal ratings in the elderly. Two widely used outcome questionnaires in Rhinology are the Nasal Obstruction Symptom Evaluation Scale (NOSE) and the Sino-Nasal Outcome Test (SNOT-20). The NOSE scale is a validated and reliable disease specific instrument designed to assess nasal obstruction [2]. The SNOT-20 is measuring health-related quality of life in sino-nasal disease [3]. The aim of the present study was to examine if the above- mentioned aging changes of nasal structure and function www.elsevier.com/locate/anl Auris Nasus Larynx 37 (2010) 303–307 * Corresponding author at: 4 Olimpiados str, Pilaia, Thessaloniki, 55535, Greece. Tel.: +30 6936933502. E-mail address: liatsak@gmail.com (E. Tsakiropoulou). 0385-8146/$ – see front matter # 2009 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.anl.2009.09.012