Pharmacists' Attitudes Towards Long-Term Use of Nasal Decongestants: A Cross-Sectional Study.

Background: Rhinitis medicamentosa is a nonallergic inflammation of the nasal mucosa caused by topical decongestants overuse. It mainly affects young and middle-aged adults. Therefore, the aim of this study was to investigate the attitudes of pharmacists regarding the utilization of over-the-counter intranasal decongestants. Methods: An online cross-sectional study was conducted from November 2021 to January 2022. The target population of the study included pharmacists who work in community pharmacies in Saudi Arabia. Binary logistic regression analysis was used to identify predictors of having positive attitude towards controlling the use of decongestant. Results: A total of 220 participants were included in this study. Around 15.0% of them reported that ND come with a physician prescription. The majority of the participants (87.3%) reported that the less than 5 days is the maximum safe duration for the use of NDs. Overall, the study participants demonstrated moderately positive attitude towards controlling the use of decongestant with a mean attitude score of 2.5 (standard deviation: 1.2) out of 5; which represents 50.0% of the maximum score. Binary logistic regression analysis identified that pharmacists aged 31-40 years were two-folds more likely to have positive attitude towards controlling the use of decongestant compared to others (p<0.05). Around 45.9% of them reported that they recommend other over-the-counter treatments like nasal irrigation, nasal steroids, or antihistamine if they see a patient with RM asking for ND with or without prescription. Conclusion: The majority of pharmacists in Saudi Arabia demonstrated sufficient awareness and understanding on the adverse effects associated with the excessive use of NDs. Rhinitis medicamentosa can be avoided by appropriate measures, highlighting the importance of raising awareness about the excessive use of decongestants among healthcare professionals and patients alike.

Understanding olfactory dysfunction in the COVID-19 era: insights from a cross-sectional survey of the Saudi community.

Background and objectives: COVID-19 has emerged as a public health emergency caused by the coronavirus 2 (SARS-CoV2). However, only a few studies have reported that anosmia is an early predictor of COVID-19. Therefore, this study aimed to assess the current level of knowledge regarding smell dysfunction in COVID-19 era in Saudi community. Materials and methods: An online survey was conducted using Survey Monkeys in Saudi Arabia. The survey was distributed through Twitter and WhatsApp. The questionnaire included individuals' demographic information, such as sex, age, residence, income, and qualifications, as well as their knowledge of the early symptoms of COVID-19. ANOVA and Mann-Whitney U-test were conducted to analyze the data. There were twelve items on knowledge dimensions which were assessed through five-point Likert scale. Results: In total, 809 respondents completed the questionnaire. Among them, 658 (81.3%) had no knowledge of how sudden loss of or change in the sense of smell can be the only symptom of COVID-19. However, most participants, 738 (91.2%), knew that fever was a symptom of COVID-19. Similarly, 707 (87.4%) and 772 (95.5%) participants knew that cough and shortness of breath were the major symptoms of COVID-19, respectively. In addition, 395 (48.3%) participants had no information regarding taste changes as a symptom of COVID-19. Notably, participants who were female, married, or diagnosed with COVID-19 had significantly greater knowledge of smell-related issues due to COVID-19 than males, unmarried, and healthy/those without COVID-19. Conclusion: This study revealed that the Saudi population has an fairly good level of knowledge regarding common COVID-19 symptoms as more than 90% of the participants understood symptoms of COVID-19, but less acceptable knowledge regarding smell and taste dysfunction as more than 80% had no knowledge of change in olfactory and taste function was due to COVID-19.

Experience of People With Chronic Sinusitis During COVID-19 Lockdown in Saudi Arabia: Insights and Lessons.

Background This study aims to evaluate the effect of the COVID-19 lockdown period on chronic rhinosinusitis (CRS) symptoms control. Methodology This cross-sectional study was carried out on adult patients (aged ≥18 years) who visited King Abdulaziz University Hospital within six months before the lockdown starting date. Background information, including patients' diagnosis, presence of rhinitis, number of previous surgeries, and medications, was collected. CRS symptom burden was measured using a validated Arabic version of the 22-item Sino-Nasal Outcome Test (SNOT-22). Study participants were required to complete the survey two months after the start of the lockdown. Results Out of 66 patients, 43 agreed to participate. The majority of respondents (34, 75.6%) were diagnosed with CRS with nasal polyps. The study revealed no differences between pre- and post-lockdown total symptom scores. Conclusions The COVID-19 pandemic has affected the health system worldwide in many ways. Regarding the scope of our study, CRS symptoms, fortunately, did not worsen with the pandemic. This is considered the first reported study to assess such symptom control among people with CRS in Saudi Arabia during the COVID-19 lockdown period.

Tonsillectomy Outcomes for Coblation Versus Bipolar Diathermy Techniques in Adult Patients: A Systematic Review and Meta-Analysis.

INTRODUCTION AND AIMS: There is no consensus on the optimal tonsillectomy technique in adult patients. The study aims to identify all studies comparing the outcomes of coblation versus bipolar diathermy in adult patients undergoing tonsillectomy. METHODS: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Primary outcomes were hemorrhage and postoperative pain. Secondary outcome measures included return to theatre, analgesia, intraoperative bleeding, diet, tonsillar healing, and operation time. Fixed-effects modeling was used for the analysis. RESULTS: Six studies were identified enrolling a total of 1824 patients. There were no significant differences in terms of reactionary hemorrhage (OR = 1.81, P = .51), delayed hemorrhage (OR = 0.72, P = .20), or postoperative pain (mean difference = -0.15, P = .45); however, there is a general trend favuring coblation. For secondary outcomes, no significant differences noted in terms of intraoperative bleeding, diet, and cases returning to theatre. Analgesia administration was either insignificant or higher in the coblation group. The coblation group had longer operation time and greater healing effect on tonsillar tissue. CONCLUSIONS: There were no significant differences in outcomes for coblation and bipolar diathermy for adult tonsillectomy patients in this systematic review and meta-analysis.

Cross-Cultural Adaptation, Validation, and Arabic Translation of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7)

Abstract Introduction The Eustachian Tube Dysfunction Patient Questionnaire (ETDQ-7) scale is used to assess the effectiveness of the treatment and to determine the severity of the eustachian tube dysfunction (ETD). There is currently no validated Arabic version of the ETDQ-7. Objectives The aim of the present study is to test the validity and the reliability of a translated Arabic version of the ETDQ-7. Methods A multicenter prospective validation study was conducted in Riyadh, Saudi Arabia. The ETDQ-7 was adapted and translated into Arabic using a standard validation methodology. Fifty-one patients diagnosed with Eustachian tube dysfunction and 45 healthy individuals were enrolled in the study. The known-groups method was used in the validity analysis. The test-retest method, item-total score correlation, and internal consistency analysis were used for the reliability analyses. Result The overall internal consistency of the Arabic ETDQ items was measured using Cronbach α (Cronbach α = 0.803). The average and total ETDQ scores were significantly higher in the ETD group (17.6) than in the control group (9.87) (p < 0.001). The results indicate a good to excellent correlation (> 0.7). The area under the curve for the total ETDQ score was 88.6% (95% confidence interval [CI]: 80.3-96.8%) Conclusion The Arabic version of the ETDQ-7 scale is a valid instrument for evaluating ETD. It can also be used as an important tool for diagnosis, patient follow-up, and treatment management.

Cross-Cultural Adaptation, Validation, and Arabic Translation of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7).

Introduction The Eustachian Tube Dysfunction Patient Questionnaire (ETDQ-7) scale is used to assess the effectiveness of the treatment and to determine the severity of the eustachian tube dysfunction (ETD). There is currently no validated Arabic version of the ETDQ-7. Objectives The aim of the present study is to test the validity and the reliability of a translated Arabic version of the ETDQ-7. Methods A multicenter prospective validation study was conducted in Riyadh, Saudi Arabia. The ETDQ-7 was adapted and translated into Arabic using a standard validation methodology. Fifty-one patients diagnosed with Eustachian tube dysfunction and 45 healthy individuals were enrolled in the study. The known-groups method was used in the validity analysis. The test-retest method, item-total score correlation, and internal consistency analysis were used for the reliability analyses. Result The overall internal consistency of the Arabic ETDQ items was measured using Cronbach α (Cronbach α = 0.803). The average and total ETDQ scores were significantly higher in the ETD group (17.6) than in the control group (9.87) ( p < 0.001). The results indicate a good to excellent correlation (> 0.7). The area under the curve for the total ETDQ score was 88.6% (95% confidence interval [CI]: 80.3-96.8%) Conclusion The Arabic version of the ETDQ-7 scale is a valid instrument for evaluating ETD. It can also be used as an important tool for diagnosis, patient follow-up, and treatment management.

Evaluation of Secondary Post-Tonsillectomy Bleeding among Children in Saudi Arabia: Risk Factor Analysis.

BACKGROUND: Tonsillectomy is one of the most widely recognized surgeries for tonsillitis. It is the default surgery option for obstructive sleep apnea, recurrent tonsillitis, and recurrent peritonsillar abscess. However, there are limited risk factor analyses in Saudi Arabia related to tonsillectomy. The goal of study is to evaluate and analyze the risk factors for secondary post-tonsillectomy bleeding in Saudi Arabia. METHOD: This retrospective review study was directed at King Abdullah Specialized Children's Hospital, Riyadh, Saudi Arabia. Univariate and multivariate investigations were performed to decide the risk factors. RESULTS: A total of 713 children were included. Post-tonsillectomy bleeding occurred in only 5.3% of tonsillectomies. There was no seasonal variation impact on post-tonsillectomy bleeding rate (P = .8). The multivariate analysis showed a significant association between post-tonsillectomy bleeding and both age (odds ratio [OR] = 1.156; 95% CI: 1.007-1.326; P = .039) and sleep disorder breathing/obstructive sleep apnea (OR = 3.581; 95% CI: 1.454-8.820; P = .006). CONCLUSION: This study revealed that age, sleep disorder/obstructive sleep apnea, and longer hospital stay after tonsillectomy are significant risk factors for post-tonsillectomy bleeding. This study provides an important baseline for further local studies in the future.

Indications and Outcomes of Parotidectomy in Saudi Children: Experience From Two Tertiary Centers.

Introduction Children can present with a wide variety of parotid diseases. However, most of them do not require surgical treatment. The indications of parotid surgery in children may differ from those in adults. In this study, we aim to review the indications and outcomes of parotidectomy in our pediatric population. Methods Retrospective review of the medical records of patients who underwent parotid surgery at age <18 years in two tertiary centers over a 14-year period. Results A total of 18 parotidectomies were performed on 18 patients with a mean age of 13.5 years. All patients presented with a parotid mass. The most common procedure was superficial parotidectomy followed by total parotidectomy. Ten patients were diagnosed with a benign parotid disease (55.6%). The most common benign disease was pleomorphic adenoma. There were eight cases of parotid malignancy constituting 44.4% of all patients and 57% of patients presenting in the age range of 12-17 years. Mucoepidermoid carcinoma was the most common malignancy (six patients). Fine needle aspiration biopsy was performed in 12 children with a sensitivity, specificity, and overall accuracy of 62.5%, 50%, and 58.6%, respectively. The most common complication was temporary facial weakness (33.3%) which resolved in a mean time of 2.5 months. No disease recurrences were identified. Conclusions Parotidectomy is uncommon in the pediatric age group. Children with a solid parotid tumor have a higher risk of parotid malignancy when compared to adults. A parotid mass presenting in the second decade of life is more likely to be malignant than benign.

Prevalence of Metastasis and Involvement of Level IV and V in Oral Squamous Cell Carcinoma: A Systematic Review.

The occurrence of occult metastases in oral cavity squamous cell carcinoma (OSCC) to lower levels in the neck (levels IV and V) or development of skip metastases that bypass the upper neck levels (levels I to III) and go directly to level IV or V is common. This challenges the efficacy of conventional neck dissection approaches in the treatment of OSCC. Therefore, the decision to include lower levels cervical nodes during elective neck dissection of OSCC remains controversial. This systematic review was designed to assess the prevalence of level IV and/or V involvement or skip metastases in patients with the clinically negative neck (cN0) or positive (cN+) oral squamous cell carcinoma (OSCC). We searched for studies published between December 2000 and December 2020. Potentially relevant abstracts and full-text articles were screened, and data from the studies were extracted. Quality was rated using the Newcastle Ottawa Scale (NOS) criteria. In total, 802 abstracts and 227 full-text articles were screened, and 32 studies were included in this analysis. The prevalence of metastasis ranged from 1.8% to 66.0%. The incidence for skip metastasis to level IV or V was low, reaching 8.5%. Evidence favored elective neck dissection, including levels I to III, in selected patients with OSCC and patients with cN0 or cN+ neck. The literature was non-conclusive on the recommendation for inclusion of lower levels.

Seasonal variations in serum levels of vitamin D and other biochemical markers among KSA patients prior to thyroid surgery.

OBJECTIVES: Serum levels of vitamin D can vary between seasons, which may affect serum calcium levels in post-thyroidectomy patients. This study aimed to determine seasonal variations in serum levels of vitamin D and other biochemical markers in patients prior to thyroid surgery in a KSA hospital. METHODS: In this study, we analysed the data of 685 post-thyroidectomy patients. The preoperative laboratory values of all patients were collected, and the patients were categorized into groups based on the month when the surgical procedure was performed as follows: cold (November-February) and warm/hot groups (March-October). RESULTS: Serum vitamin D levels were deficient in 70% of the patients, insufficient in 18%, and optimal in 12%. The mean age of patients in the deficient group was significantly lower than that in the optimal group. There were significantly more patients who had vitamin D deficiency during the cold season than during the warm/hot season (p = 0.024). Serum vitamin D levels did not vary between seasons (p = 0.836); however, the preoperative magnesium and thyroid stimulating hormone (TSH) levels were significantly higher during the warm/hot season than during the cold season (p = 0.039 and p < 0.001, respectively). Preoperative calcium level was not significantly different between the cold and warm/hot months (p = 0.282). CONCLUSION: This study suggests a non-significant seasonal fluctuation in serum levels of vitamin D with insignificant variation in serum calcium levels during cold and warm/hot seasons. The findings necessitate a careful review of the patients' biochemical status prior to surgery. Future prospective longitudinal studies are needed to confirm this variability.

Medical Students' Awareness of Smell Loss as a Predictor for Coronavirus Disease 2019.

Background: Anosmia has been reported as an early presentation of coronavirus disease 2019 (COVID-19). However, the pathophysiological mechanism of olfactory dysfunction is still unclear. Aim: The aim of this study to evaluate the knowledge regarding common symptoms, anosmia, treatment options, and PPE among medical students in three different universities of Saudi Arabia. Methods: This cross-sectional survey conducted among medical students in Saudi Arabia. Google Forms was used to create the survey. The questionnaire included demographic information, knowledge of COVID-19 symptoms, sources of information, and the level of awareness of specific symptoms (loss of smell and taste). Results: A total of 494 students completed the questionnaire. The majority of the participants were aware of common COVID-19 symptoms like fever and cough (79.8 and 67.2%, respectively), but less than half were aware that smell or taste dysfunction might be a symptom of COVID-19 (44.3 and 30.2%, respectively). The present study revealed that the source of information also plays a critical role in medical students' awareness regarding the symptoms of COVID-19. Students using international organization's websites, medical databases, or published research had better knowledge of anosmia as a COVID-19 symptom compared to those who used WhatsApp, Google, or unofficial social media pages. In our study, a minority (11.9%) of the participants relied on unofficial social media pages as the main source of their information. Conclusion: Saudi medical students understand that smell or taste dysfunction can be a potential symptom of COVID-19, but this knowledge was not as widespread as the knowledge regarding the most common COVID-19 symptoms.

Factors associated with facial weakness following surgery for benign parotid disease: a retrospective multicenter study.

BACKGROUND: Facial nerve weakness is the most common and most concerning complication after parotidectomy. Risk factors for this complication following surgery for benign diseases remain controversial. OBJECTIVE: Review the frequency and prognosis of facial nerve weakness after parotidectomy and analyze potential risk factors. DESIGN: Retrospective review of medical records. SETTINGS: Two tertiary care centers. PATIENTS AND METHODS: We included all parotidectomies performed for benign diseases from January 2006 to December 2018. Details about the development and recovery of postoperative facial weakness were recorded. Patient, disease and surgery-related variables were analyzed using bivariate and multivariate analyses to identify risk factors. MAIN OUTCOME MEASURES: Frequency, recovery rates and risk factors for facial nerve weakness SAMPLE SIZE: 191 parotidectomies, 183 patients, 61 patients with facial weakness. RESULTS: The frequency of postoperative facial weakness was 31.9% (61/191 parotidectomies). Among patients with temporary weakness, 90% regained normal facial movement within 6 months. Steroid therapy was not associated with a faster recovery. Postoperative weakness was not associated with age, diabetes, smoking, disease location, use of an intraoperative facial nerve monitor or direction of facial nerve dissection. Risk factors for temporary weakness were total parotidectomy and surgical specimens larger than 60 cubic centimeters. Revision surgery was the only identified risk factor for permanent weakness. CONCLUSION: Larger parotid resections increase the risk of temporary facial nerve weakness while permanent weakness is mainly influenced by previous surgeries. LIMITATIONS: Retrospective nature, underpowered sample size, selection bias associated with tertiary care cases. CONFLICT OF INTEREST: None.

Validation and inter-rater reliability testing of the Arabic version of speech intelligibility rating among children with cochlear implant.

OBJECTIVES: To validate and assess the reliability of the new version of an Arabic speech intelligibility rating among di erent raters. METHODS: This cross-sectional analysis was carried out between December 2018 and January 2019. Thirty cochlear-implant (CI) children (study group) and 30 subjects (control group) were enrolled. Study candidates' speech skills were evaluated using the translated Arabic SIR by parents and original SIR by professions such as speech-language pathologists (SLPs). Inter-rater agreement, test-retest reliability, pre- and post-intervention score (responsiveness test), patient versus control score comparison (discriminant validity), and cross-validation of Arabic SIR have all been assessed. RESULTS: There was a good sense of agreement between the post-operative SIR parents' assessments and the professional SLPs' assessments (r=0.920, p less than 0.001). The mean of study subjects pre- and post-implantation score of Arabic SIR showed a statistically significant difference (p less than 0.001). CONCLUSION: The Arabic SIR demonstrated excellent reliability with strong consistency. It showed its clinical ability in distinguishing healthy subjects from patients along with follow up of speech development skills over time. The Arabic SIR can be used by parents to evaluate post-CI progress of their children.

Grisel's syndrome post otolaryngology procedures: A systematic review.

OBJECTIVE: To increase awareness and the index of suspicion regarding Grisel's syndrome among otolaryngologists after otolaryngology procedures. METHOD: We conducted a search of MEDLINE/PubMed for articles published through January 2020 utilizing the following terms: Grisel's syndrome, Grisel syndrome, and atlantoaxial subluxation alone and in combination with other terms like ENT, otolaryngology, head & neck, tonsillectomy, adenoidectomy, adenotonsillectomy, mastoidectomy, tympanoplasty, and tympanomastoidectomy. We included English-language cases that occurred after surgical procedures and contained the following data: age, onset, common presenting symptoms, diagnostic approach, management options, and the presence of complications. RESULT: We found 39 papers that met our criteria. Most cases occurred after adenotonsillectomy with or without ventilation tube insertion (55.6%). The majority of the affected population was the pediatric age group, and the main presenting symptom was torticollis that presents as early-onset. In regard to management, most of the cases were treated with medical therapy with or without adjunctive measures (e.g., a cervical collar). No neurological complications were recorded except in one case that was treated with no long term sequel. CONCLUSION: Grisel's syndrome is a rare complication that occurs after otolaryngology procedures and can result in serious neurological complications and death. A high index of suspicion is an important factor for early diagnosis and management to prevent such complications. In most cases, conservative management is successful with a good prognosis.

Assessment of International Frontal Sinus Anatomy Classification among senior residents through inter- and intra-rater reliability.

OBJECTIVES: To evaluate the International Frontal Sinus Anatomy Classification (IFAC) reliability among Saudi board otorhinolaryngology senior residents. METHODS: This cross-sectional study was carried out at King Abdulaziz University Hospital, Riyadh, Saudi Arabia between April 2019 and December 2019, included 32 senior residents. Questionnaires with 4 computed tomography images showing the different frontal cell types were used in this survey. All scans included 3 planes (axial, sagittal, coronal) and the tested cell was marked with arrows. Residents chose the answer from multiple choices according to the IFAC system. All residents filled the same questionnaire twice with 2 weeks interval. RESULTS: Approximately 68.8% of residents agreed that the classification was applicable clinically. The resident's attitude toward the importance of understanding IFAC was 65.6%. Residents' correct classification of the marked cells increased significantly for most of the questions from baseline to 2 weeks. CONCLUSION: The frontal sinus is not easy to treat surgically, and its inadequate treatment causes the failure of drainage, as in the case of chronic rhinosinusitis. Therefore, surgeons must fully understand the IFAC system to avoid major and minor complications.

Awareness of head and neck cancers in Saudi Arabia. A questionnaire based study.

OBJECTIVES: To address the gap in knowledge by providing data and analyses of the status of awareness among Saudi adults. METHODS: This cross-sectional questionnaire-based study was carried out in Saudi Arabia from August 2018 to August 2019 through social media platforms using SurveyMonkey. The domains of the questionnaire included demographic information, knowledge of types and symptoms of head and neck cancers (HNCs), and the relation of HNCs to human papillomavirus (HPV) and its vaccine. RESULTS: A total of 3171 respondents completed the questionnaire. The analysis revealed that many of the study respondents (49.3%) were not knowledgeable about HNCs. Almost two-thirds (61.2%) of the study population incorrectly believed that brain cancer was included in HNCs. Over half (57.8%) did not recognize headaches as a symptom. In terms of the risk factors, males showed higher awareness of tobacco and excessive alcohol as risk factors, while females were more knowledgeable about HPV infection (p less than 0.05). CONCLUSION: This study revealed that there is a lack of knowledge and awareness of the clinical features of and risk factors for HNCs among the Saudi population.

Inter-rater Reliability and Validity of the Arabic Version of Categories of Auditory Performance-II (CAP-II) Among Children With Cochlear Implant.

BACKGROUND: Categories of Auditory Performance II (CAP-II) is an established audiological test that consists of a rating scale that can be used for prospective assessment of the auditory performance of cochlear implant (CI) recipients. OBJECTIVE: To create and validate an Arabic version of Categories of Auditory Performance scale II (CAP-II), and to evaluate its reliability. METHODS: In this cross-sectional study, 30 post-CI children (patients' group) along with 30 control subjects were included. The translated Arabic CAP-II scale has been used by speech-language pathologists and parents to evaluate the study subjects' auditory abilities. The interrater reliability, test-retest reliability, pre and postintervention score (responsiveness test), case versus control score comparison (discriminate validity), and cross-validation of the new Arabic version of CAP-II have been assessed. RESULTS: The Arabic CAP-II demonstrated high test-retest and inter-rater reliability. There was a positive correlation between the Arabic CAP-II and Meaningful auditory integration scale. The Arabic CAP-II scores were higher in the patients' group compared with control subjects. CONCLUSION: The Arabic CAP-II showed high inter-rater reliability with excellent concurrent and discriminate validity. The Arabic version of CAP-II seems to be a valid and reliable tool in assessing different auditory performance in Arabic speaking children with hearing impairment.

Does skin thickness affect satisfaction post rhinoplasty? Middle Eastern population as an example.

OBJECTIVES: To determine the mean nasal skin thickness in the Middle Eastern population and to assess the effect of skin thickness on patients' satisfaction following rhinoplasty surgeries. Methods: Radiological measurements of skin thickness at the 3 vertical thirds of the nasal dorsum were taken. A total of 154 patients (80 females and 74 males) who were scheduled for computed tomography scan for the paranasal sinuses were included in the study. The patients were then categorized into 3 groups: thick, medium, and thin nasal skin. A scale from 10% to 100% was used to assess patient satisfaction following rhinoplasty. Satisfaction and skin thickness were analyzed using the Kruskal-Wallis test. Results: Nasal skin thickness for males was 6.13, 2.76 millimeter (mm) from the upper and 3.70 mm to the lower third. For females, it was 5.34, 2.13 mm from the upper and 3.21 mm to the lower third. There was no statistically significant difference in patient satisfaction among the 3 skin thickness groups (p=0.089). Conclusion: This study provides baseline results of nasal skin thickness in the Middle Eastern population. The results also show that nasal skin thickness may not be a strong factor affecting patient satisfaction.

Translation, validation, and cultural adaptation of the Rhinosinusitis Disability Index and the Chronic Sinusitis Survey into Arabic.

BACKGROUND: Disease-specific quality of life instruments assess the impact of chronic rhinosinusitis on patients' quality of life (QoL). To the extent of our knowledge, there are no Arabic versions of two instruments-the Rhinosinusitis Disability Index (RSDI) and the Chronic Sinusitis Survey (CSS). OBJECTIVE: Develop an Arabic-validated version of both instruments, thus allowing its use among the Arabic population. DESIGN: Prospective cross-sectional study for instrument validation. SETTING: Tertiary university hospital. SUBJECTS AND METHODS: This study was conducted between September 2015 and October 2016. We followed the international comprehensive guidelines for translation and cross-cultural adaptation of QoL instruments. MAIN OUTCOME MEASURES: Test-retest reliability, discriminant validity, and responsiveness ability of both the RSDI and CSS Arabic versions. SAMPLE SIZE: 124. RESULTS: The sample comprised 75 patients diagnosed with chronic rhinosinusitis and 49 healthy control subjects. The Arabic version of both instruments showed high internal consistency (Cronbach's alpha: RSDI=0.97, CSS=.88) and the ability to differentiate between diseased and healthy volunteers (P less than .0001). The translated versions also detected significant change in response to an intervention (P less than .0001). CONCLUSION: These Arabic validated versions of the RSDI and CSS can be used for both clinical and research purposes. LIMITATIONS: This study was performed in only one tertiary hospital. CONFLICT OF INTEREST: None.

Correlation between Allergic Rhinitis and Laryngopharyngeal Reflux.

BACKGROUND AND OBJECTIVES: Laryngopharyngeal reflux (LPR) exhibits nonspecific clinical presentations, and these symptoms may be associated with other conditions such as allergies, including allergic rhinitis and laryngitis. However, there is a gap in the literature regarding the correlation of laryngopharyngeal reflux with allergic rhinitis/laryngitis. Hence, the aim of this study is to explore the correlation between these two conditions. PATIENTS AND METHODS: A total of 126 patients with suggestive manifestations of laryngopharyngeal reflux were included in this study. Patients were classified into LPR positive and negative groups based on the results of a 24-hour oropharyngeal pH monitoring system while allergic rhinitis status was assessed with the score for allergic rhinitis (SFAR). THE RESULTS OF THE TWO GROUPS WERE COMPARED REGARDING THE SFAR SCORE CORRELATION BETWEEN THE PH RESULTS AND SFAR SCORE WAS EXPLORED RESULTS: The LPR positive group demonstrated significantly higher SFAR scores compared to the negative LPR group (p < 0.0001). In addition, the Ryan score was significantly correlated with the SFAR total score and its symptomatology-related items (r ranged between 0.35 and 0.5). Conclusion. It seems that laryngopharyngeal reflux increases patients' self-rating of allergic manifestations. It appears that there is an association between laryngopharyngeal reflux and allergic rhinitis/laryngitis.