Effect of Body Mass Index on Sinonasal Symptoms and Imaging Results

While sinonasal inflammation and anatomy are known to be affected by obesity, its impact on symptom severity and objective imaging findings remain unknown. This study assessed whether body mass index (BMI) influences sinonasal symptom severity, as measured by the 22-item Sinonasal Outcome Test (SNOT-22), and whether BMI modifies the relationship between SNOT-22 scores and Lund-Mackay (LM) CT scores. Analysis of 173 patients categorized by BMI revealed no significant differences in overall or domain-specific SNOT-22 scores. Additionally, BMI did not modify the association between symptom severity and imaging findings. These results suggest that, despite known mechanistic and epidemiologic associations between obesity and sinonasal symptoms, BMI alone does not impact the extent of sinonasal symptoms, nor does it influence the relationship between subjective symptoms and radiographic disease. Presenting these data, which may diverge from prior results, preempts the typical trend toward positive publication bias.