| Symptom | No problem | Very mild | Mild | Moderate | Severe | Extremely severe |
| Dryness | 0 | 1 | 2 | 3 | 4 | 5 |
| Sense of diminished airway | 0 | 1 | 2 | 3 | 4 | 5 |
| Suffocation | 0 | 1 | 2 | 3 | 4 | 5 |
| Nose feels too open | 0 | 1 | 2 | 3 | 4 | 5 |
| Nasal crusting | 0 | 1 | 2 | 3 | 4 | 5 |
| Nasal burning | 0 | 1 | 2 | 3 | 4 | 5 |