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Objectives:  We set out to determine the psychometric validation of a disease‐specific health related quality of life instrument for use in chronic rhinosinusitis, the 22 item Sinonasal Outcome Test (SNOT‐22), a modification of a pre‐existing instrument, the SNOT‐20.

Design, setting and participants:  The National Comparative Audit of Surgery for Nasal Polyposis and Chronic Rhinosinusitis was a prospective cohort study collecting data on 3128 adult patients undergoing sinonasal surgery in 87 NHS hospitals in England and Wales. Data were collected preoperatively and at 3 months after surgery, and analysed to determine validity of the SNOT‐22. Test–retest reliability was assessed in a separate cohort of patients in a single centre.

Main outcome measures:  The SNOT‐22, a derivative of the SNOT‐20 was the main outcome measure. Patients were also asked to report whether they felt better, the same or worse …