Cross-cultural adaptation of the Hebrew Nasal Obstruction Symptom Evaluation (NOSE) scale

Amani Daoud, Netanel Eisenbach, Ohad Ronen, Amiel Dror, Tali Jane Ohayon, Majd Hajouj, Eyal Sela, Tal Marshak

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1 Scopus citations


Objective: Nasal obstruction is a common complaint. The Nasal Obstruction Symptom Evaluation scale (NOSE) is a reliable validated tool used to assess the quality of life of patients with nasal obstruction. The purpose of this study is to validate the Hebrew version of the NOSE scale (He-NOSE). Methods: A prospective instrument validation was conducted. The NOSE scale was translated primarily from English to Hebrew and then back from Hebrew to English according to the accepted guidelines of the cross-cultural adaptation process. The study group included surgery candidates suffering from nasal obstruction due to a deviated nasal septum and/or inferior turbinate hypertrophy. The study group completed the validated He-NOSE questionnaire twice prior to the surgery and once again, a month post-surgery. A control group of individuals with no history of nasal complaints or surgeries was asked to complete the questionnaire once. Reliability, internal consistency, validity, and responsiveness to change of the He-NOSE were evaluated. Results: Fifty-three patients and 100 controls were included in this study. The scale showed excellent ability to discriminate between the study and the control group, exhibiting significantly lower scores in the control group (73.8 and 7 average scores respectively, p <.001). Good internal consistency (Cronbach's alpha.71 and.76) and test–retest reliability (Spearman rank correlation r =.752, p <.0001) were measured. Moreover, the scale revealed remarkable responsiveness to change (p <.00001). Conclusion: The translated and adapted He-NOSE scale can be a useful tool to be applied in both clinical and research fields when assessing nasal obstruction. Level of evidence: N/A.

Original languageEnglish
Pages (from-to)34-39
Number of pages6
JournalLaryngoscope investigative otolaryngology
Issue number1
StatePublished - Feb 2023

Bibliographical note

Publisher Copyright:
© 2022 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.


  • NOSE scale
  • nasal obstruction
  • quality of life
  • validation study


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