2.3 Assessment of treatment outcome
The level of clinical disease control and total nasal symptom score (TNSS) were included for the assessment of therapeutic effect in CRSwNP patients(2). Symptoms such as nasal congestion, rhinorrhea, postnasal drip and olfaction decline were incorporated in TNSS (Range of score: 0-12) , in which each symptom was assessed with zero indicating “None”, one indicating “Mild”, two indicating “Moderate” and three indicating “Severe”. The status of disease control were assessed by two otolaryngologists according to classification criteria of EPOS 2012(2). In brief, the levels of disease control were divided into controlled, partly controlled, or uncontrolled. CRS under control was determined by nearly healthy or healthy mucosa, with no troublesome symptoms and unnecessary systemic medicine for controlling disease. Patients with partly controlled condition suffered from at least one as follow: continuous nasal obstruction, mucopurulent rhinorrhea/postnasal drip, decreased sense smell, facial pain, fatigue/sleep disorder, mucosal lesion examined by endoscope, and requirement with one course of systemic steroids/antibiotics nearly a month. CRS in uncontrolled state could be determined by no less than three items from the level of partly controlled.