Today's healthcare environment demands objective assessment of surgical out
comes. The recent otolaryngologic literature has established acoustic rhino
metry (AR) as a valid instrument to objectively document nasal patency. The
purpose of this article is to evaluate the utility of AR in predicting out
comes after sinonasal surgery. All patients scheduled for sinonasal surgery
at the Tulane University and University of Mainz Departments of Otolaryngo
logy between 10/1/98 and 12/15/98 were enrolled. All subjects underwent AR
and completed a sinonasal outcome survey (SNOT-20) one day before and two m
onths after their surgical procedure. Thirty-one patients were enrolled. Th
e SNOT-20 raw scores improved from a mean of 7.93 (+/-3.78) preoperatively
to 3.35 (+/-2.33) postoperatively (p < 0.05). The I-notch revealed no signi
ficant change postoperatively. The mean bilateral predecongestion C-notch i
ncreased from 1.257 cm(2) to 1.451 cm(2) (p < 0.05). Patients with a bilate
ral C-notch >1 cm(2) were 1.96 times more likely to have a five-point impro
vement in the SNOT-20 raw score (95% CI = 1.17 3.27). The mean value of the
C-notch is significantly altered (increased) as a result of sinonasal surg
ery. Patients with a preoperative cross-sectional area <1 cm(2) are less li
kely to report large postoperative subjective improvement. These results in
dicate that patients with poor geometry at the area of the C-notch do not f
are as well surgically as those with better preoperative measurements.