Translation and Validation of the "7-Item Eustachian Tube Dysfunction Questionnaire" to European Portuguese (PT).

INTRODUCTION: Eustachian tube dysfunction is a common cause of morbidity in both adults and children, associated with nasal and otologic symptoms. Symptomatic evaluation is very important for the correct diagnosis and evaluation of the treatment efficacy of this entity. The "7-item Eustachian Tube Dysfunction Questionnaire" was described and validated by McCoul et al and proved to be a useful tool, easy to apply, with good validity in the evaluation of eustachian tube dysfunction symptoms. This study presents the validation process of the European Portuguese version of the "7-item Eustachian Tube Dysfunction Questionnaire". The aim of this study was to translate and validate the European Portuguese version of "Eustachian Tube Dysfunction Questionnaire-7". MATERIAL AND METHODS: The "7-item Eustachian Tube Dysfunction Questionnaire" was adapted and translated to European Portuguese using standard validation methodology. The European Portuguese version of "7-item Eustachian Tube Dysfunction Questionnaire" was completed by a group of 50 consecutive adult patients diagnosed with eustachian tube dysfunction and 25 healthy patients who served as a control group. All respondents in the Eustachian tube dysfunction group repeated the "7-item Eustachian Tube Dysfunction Questionnaire" in a two week-period. Statistical analysis was performed to determine its psychometric properties (reliability -internal consistency and test-retest reproducibility, and discriminant validity). RESULTS: Face and content validity were confirmed, and reliability testing revealed similar internal consistency for the entire instrument as the original questionnaire, and strong correlation between individual items and total score. The questionnaire was easy and quick to administer. Test-retest reliability of the European Portuguese version was adequate, with excellent intraclass correlation coefficients and without significant differences between the total score from the first and second evaluations. Discriminative validity was confirmed by statistically significant differences between scores of the test and control groups. DISCUSSION: This study presents the European Portuguese version of the "7-item Eustachian Tube Dysfunction Questionnaire" questionnaire, an adapted, validated and well-accepted instrument to evaluate the symptoms of eustachian tube dysfunction in the European Portuguese speaking population. CONCLUSION: The European Portuguese version of the "7-item Eustachian Tube Dysfunction Questionnaire" is recommended as a routine procedure in the assessment of patients with eustachian tube dysfunction in the European Portuguese speaking population and for the evaluation of treatment outcome.

Introdução: A disfunção da trompa de Eustáquio é uma patologia comum associada a sintomas nasais e otológicos. A avaliação sintomática desta patologia é importante para o seu correto diagnóstico e avaliação da resposta ao tratamento implementado. O "7-item Eustachian Tube Dysfunction Questionnaire", descrito e validado por McCoul et al, demonstrou tratar-se de uma ferramenta adequada, de fácil e rápida aplicação, com boa reprodutibilidade na avaliação dos sintomas de disfunção da trompa de Eustáquio. Este estudo apresenta o processo validação da versão Portuguesa do "7-item Eustachian Tube Dysfunction Questionnaire". O objectivo deste trabalho foi a adaptação e validação do "7-item Eustachian Tube Dysfunction Questionnaire" para a língua portuguesa. Material e Métodos: O "7-item Eustachian Tube Dysfunction Questionnaire" foi traduzido e adaptado para língua portuguesa, de acordo com a metodologia recomendada na literatura científica. A versão portuguesa foi aplicada a um grupo teste de 50 doentes consecutivos com o diagnóstico de disfunção da trompa de Eustáquio e a um grupo de controlo de 25 pessoas. Todos os doentes com disfunção da trompa de Eustáquio repetiram o questionário num período de duas semanas. Foi realizada análise estatística para determinar as suas propriedades psicométricas (consistência interna, reprodutibilidade teste-reteste e validade discriminatória). Resultados: O "7-item Eustachian Tube Dysfunction Questionnaire" traduzido apresentou uma consistência interna similar à do questionário original para cada item e uma forte correlação item-total. A aplicação do questionário foi fácil e rápida. Verificou-se boa reprodutibilidade teste- reteste da versão traduzida do questionário, com excelentes coeficientes de correlação intraclasse e sem diferenças significativas entre o valor total das primeira e segunda medições. A validade discriminatória foi confirmada através da diferença estatisticamente significativa entre a pontuação do grupo teste e grupo controlo. Discussão: Este estudo demonstra que a versão portuguesa do "7-item Eustachian Tube Dysfunction Questionnaire", é um instrumento adaptado, validado e bem aceite para a avaliação dos sintomas de disfunção da trompa de Eustáquio na população portuguesa. Conclusão: A versão portuguesa do "7-item Eustachian Tube Dysfunction Questionnaire" é recomendada para o rastreio de disfunção da trompa de Eustáquio na população Portuguesa e para a monitorização da resposta ao seu tratamento.

Management of pediatric peritonsillar and deep neck infections- cross- sectional retrospective analysis.

OBJECTIVE: Deep neck infections (DNI) are responsible for significant morbidity in children and healthcare expenditures. Few studies exist specifically addressing the clinical and epidemiologic characterization and management of DNI's in the pediatric population. Our goal was to analyse the demographic characteristics, clinical presentation, diagnostic and therapeutic approaches of peritonsillar and DNI in pediatric patients. METHODS: The medical records of patients, aged up to 18 years, admitted for peritonsillar and DNI at our department, from 2011 to 2016, were retrospectively reviewed and compared with the literature available. Ninety-eight patients were enrolled. RESULTS: The mean age was higher in patients with peritonsillar abscess and lower in patients with retropharyngeal and parapharyngeal infections. Admissions have significantly increased from 2011. There was a seasonal variation for DNI incidence, with a peak incidence in Summer and Spring. All patients included were treated as inpatient and received empirical intravenous antibiotic therapy and steroids regardless of drainage procedures. Incision and drainage was performed in 72 patients. The hospital length of stay was higher among patients with retropharyngeal abscess and in the group with complications. Only 2 patients developed complications during hospital stay. The most common microbiological pattern was monomicrobial and the most commonly isolated pathogens were Streptococcus Pyogenes, Streptococcus Mitis and anaerobic bacteria. CONCLUSIONS: Surgical incision and drainage followed by intravenous antibiotic and steroids proved to be successfull with low morbidity related to surgical approach. However, in selected cases, medical therapy may be an alternative to surgical management in uncomplicated infections.