Posted by Dr. Anil R. Shah

Today, I am going to discuss the NOSE (Nasal Obstruction Symptom Evaluation) Scale. We have been using the NOSE Scale in our office for several years. The idea with this survey is trying to find an objective measure of the patient’s breathing. Essentially it’s a series of questions that are rated on the scale of zero to four. Zero being not a problem and four being a severe problem.

The idea here is that the patient will complete the survey and try to define their breathing prior to surgery and then again post-procedure. After the procedure, the NOSE Scale numbers are smaller.

WHAT ARE THE QUESTIONS FOR THE ‘NOSE’ SCALE?

The first question asks about congestion and stuffiness. The second question is in regards to nasal blockage or obstruction. The third question is related to trouble breathing through the nose. The fourth question asks the patient about trouble sleeping. Finally, the fifth is if the patient is able to get enough air through the nose during exercise or exertion. The highest nasal score would be a 20 while the lowest would be a 0.

WHEN WILL THE PATIENT TAKE THE ‘NOSE’ SCALE SURVEY?

When patients come into our office for their consultation, we initially ask them these questions. Post-procedure and subsequent visits afterwards, we will ask these same questions in regards to the procedure that was done and what kind of intervention this has had for the patient. This could be from the results of a rhinoplasty, a septoplasty, or even from the use of inhalation of spray.

IS  THE ‘NOSE’ SCALE PERFECT?

Most patients are not conscious of their breathing. So, the scale is a good tool but not perfect. I think an ideal measurement would be to be able to quantitatively measure someone’s breathing and their airflow. The nose scale does give us that sort of measure of how breathing is at that point.


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