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Introduction: SNOT-22 is a screening tool universally applied in perioperative settings for endoscopic sinus surgery (ESS), typically for chronic rhinosinusitis (CRS). Comorbid obstructive sleep apnea (OSA) increases risk of perioperative complications following ESS, yet pre-ESS OSA screening is not performed. This study sought to determine whether the sleep subdomain SNOT-22 (SD-SNOT) score could be useful for OSA screening.

Methods: A retrospective study was performed by reviewing electronic records of 108 patients that underwent endoscopic sinus surgery between November 2019 – January 2020. Pre-operative and 2 months post-operative SD-SNOT scores were compared with the presence or absence of OSA.

Results: Mean sleep pre-ESS scores was 16.04±11.95 while 2-month post-operative score was 8.84±10.55. SD-SNOT score preoperatively (22.4±12.9 vs. 14.7±11.4; p=0.02) and post-operatively (20.8±15.0 vs. 6.8±8.6; p=0.02) were significantly higher in the OSA cohort. The lowest SD-SNOT scores that were significantly associated with diagnosis of OSA were 21 for preoperative (OR: 3.5; CI:1.1-10.7; p=0.02) and 16 for postoperative (OR:10.5; CI:1.3-83.5; p=0.03).

Discussion: SD-SNOT is a useful parameter in screening for OSA. Scores > 20 preoperatively and >15 at 2 months postoperatively may indicate comorbid OSA. These results allow the repurposing of SNOT-22, an already widespread perioperative tool, to be used to detect potential undiagnosed OSA among chronic rhinosinusitis patients.