Validated patient-reported outcome measure

Nasal Obstruction Symptom Evaluation (NOSE)

Official scoring contract

Rate each symptom over the past one month. Choose one response in every row; your score appears when the form is complete.

Response scale: 0 = not a problem, 1 = very mild, 2 = moderate, 3 = fairly bad, 4 = severe. The five responses are added and multiplied by 5 (range 0–100).

SymptomNot a problemVery mild problemModerate problemFairly bad problemSevere problem

1.Nasal congestion or stuffiness

2.Nasal blockage or obstruction

3.Trouble breathing through my nose

4.Trouble sleeping

5.Unable to get enough air through my nose during exercise or exertion

Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT. Development and validation of the NOSE scale. Otolaryngol Head Neck Surg. 2004;130:157–163.

AAO-HNS outcome-tool page

GIRFT pathway context: the July 2025 adult referral guidance says people scoring over 30 are most likely to benefit from surgical intervention. The January 2026 functional septorhinoplasty pathway uses a score over 50 as one criterion alongside structural pathology, functional restriction and inadequate benefit from septoplasty alone. A score does not determine treatment by itself.

GIRFT adult referral guidance GIRFT nasal airway surgery pathway