The Sino-Nasal Outcome Tests (SNOT) were originally developed by Dr. Piccirillo as the Rhinosinusitis Outcome Measure-31 (RSOM-31) to measure the physical, functional, and emotional consequences of rhinosinusitis.1

The items were identified through discussions with patients and providers.  Over the years, the number of items has changed and new items identified (i.e., “productivity”). There are now 4 different SNOT instruments based on the number of items – SNOT-252, SNOT-223, SNOT-204, SNOT-165

The SNOT instruments have been translated into more than 70 different languages and more than 93% of the world’s population speaks a language that has a SNOT instrument.  The SNOT can also be used for quality improvement projects.


Rhinosinusitis Outcome Measure (RSOM-31) »

SNOT-16 »

SNOT-20 »

SNOT-22 »

SNOT-25 »

  1. Piccirillo JF, Edwards D, Haiduk A, Yonan C, Thawley SE. Psychometric and clinimetric validity of the 31-item rhinosinusitis outcome measure (RSOM-31). Am J Rhinol. 1995;9:297-306.
  2. Tait SD, Kallogjeri D, Chidambaram S, Schneider J, Piccirillo JF. Psychometric and Clinimetric Validity of the Modified 25-Item Sino-Nasal Outcome Test. Am J Rhinol Allergy. 2019:1945892419851622.
  3. Hopkins C, Gillett S, Slack R, Lund VJ, Browne JP. Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol. 2009;34(5):447-454.
  4. Piccirillo JF, Merritt MGJ, Richards ML. Psychometric and clinimetric validity of the 20-Item Sino-Nasal Outcome Test (SNOT-20). Otolaryngology – Head & Neck Surgery. 2002;126(1):41-47.
  5. Garbutt J, Spitznagel E, Piccirillo J. Use of the modified SNOT-16 in primary care patients with clinically diagnosed acute rhinosinusitis. Arch Otolaryngol Head Neck Surg. 2011;137(8):792-797.