The Role of Sex on Early Cochlear Implant Outcomes.

OBJECTIVE: To determine the presence of sex differences in cochlear implant outcomes. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary referral center. PATIENTS: Adult patients having undergone cochlear implantation from 2009 to 2017. INTERVENTION(S): Standard electrode length cochlear implantation. MAIN OUTCOME MEASURE(S): AzBio scores in quiet of the implanted ear at the 1 to 3 months and 6 to 9 months postoperative time points. RESULTS: Of 55 patients with complete demographic and speech recognition testing, 36.4% (n = 20) were men. The mean age at time of surgery was 59.81 ±â€Š16.54 years and the mean duration of hearing loss was 26.33 ±â€Š18.54 years; there was no significant difference between men and women. The mean preoperative AzBio score was 11 ±â€Š15.86% and there was no difference between men and women. Through 2 (sex) × 3 (time point) analysis of covariance (ANCOVA), there was no main effect of sex (F[1, 48] = 0.74, p = 0.39, η = 0.02) on postoperative AzBio scores, but there was a significant sex by time point interaction, (F[1.77, 85.03] = 4.23, p = 0.02, η = 0.08). At the 1 to 3 months postoperative time point, women exhibited higher relative improvement in AzBio scores than men (67 ±â€Š27% versus 55 ±â€Š31%). Further, this relative improvement increased and remained significant at the 6 to 9 months postoperative time point (women: 71 ±â€Š22% versus 58 ±â€Š30%). CONCLUSIONS: Sex may play a role in early speech recognition outcomes after adult cochlear implantation.

Short-term effects of patellar kinesio taping on pain and hop function in patients with patellofemoral pain syndrome.

BACKGROUND: Patellofemoral pain syndrome (PFPS) is the most prevalent orthopaedic condition among physically active individuals, contributing to an estimated 30% to 40% of all sports medicine visits. Techniques using Kinesio Tape (KT) have become increasingly popular; however, there has been scant research supporting its use on patients with PFPS. HYPOTHESIS: The use of patellar KT to treat patients with PFPS will provide a statistically significant improvement in short-term pain and single-leg hop measures as compared with sham placement of KT. STUDY DESIGN: Nonrandomized controlled clinical trial with repeated-measures design. LEVEL OF EVIDENCE: Level 3. METHODS: Forty-nine subjects (41 females, 8 males) between the ages of 12 and 24 years with PFPS participated in this study. Each subject underwent patellar kinesio taping with both experimental and sham applications while completing 4 functional tasks and the single-leg triple jump test (STJT). The treatment outcome was analyzed using separate paired t tests to measure improvement on a numeric pain rating scale. A 2-way, 2 × 2 analysis of variance was used to analyze the relationship between taping condition (experimental vs sham) and side (involved vs uninvolved) for STJT scores. RESULTS: Separate paired t tests found step-up, step-down, and STJT pain improvement statistically significant between taping conditions. The 2-factor analysis of variance yielded a significant main effect for taping condition, but the main effect for side was not significant. The interaction between taping condition and side was significant. This showed there was little change in STJT distance between repeated measures performed on the untaped, noninvolved leg. However, subjects' STJT distances were significantly greater for the experimental KT application than the sham application for the involved side. CONCLUSION: Patellar kinesio taping provided an immediate and statistically significant improvement in pain and single-leg hop function in patients with PFPS when compared with a sham application. However, improvement in STJT scores did not surpass the minimally detectable change value, and therefore, the clinical effectiveness of KT for improving single-leg hop function was not established in the current study. CLINICAL RELEVANCE: Kinesio Tape provides a viable, short-term method to control pain.

Laryngeal papillomatosis associated dysplasia in the adult population: an update on prevalence and HPV subtyping.

OBJECTIVES: The objectives were to determine the prevalence of laryngeal dysplasia and associated human papilloma virus (HPV) subtypes in adult patients, 18 years or older, suffering from laryngeal papillomatosis at a tertiary care institution. STUDY DESIGN: Retrospective cohort study. METHODS: Patients with biopsy proven laryngeal papillomatosis were identified via chart review. All available pathology specimens were reviewed by a dedicated head and neck pathologist to confirm/refute the diagnosis of laryngeal dysplasia, and grade the level of dysplasia. Interrater agreement was compared using cross-tabulation methods. Specimens identified to be positive for dysplasia underwent further testing via in situ hybridization for low-risk (6/11) or high-risk (16/18) HPV subtypes. RESULTS: Of the 85 subjects identified to have laryngeal papillomatosis, 24(28%) demonstrated laryngeal dysplasia. There was good interrater agreement on the presence of dysplasia; however, there was only fair agreement on the grade of dysplasia. Of the pathology specimens tested for HPV subtype, the majority of patients (62%) were positive for HPV 6/11, including all high-grade dysplasia patients. Three (12%) dysplasia specimens were negative for both high- and low-risk HPV subtypes. CONCLUSIONS: We found a 28% prevalence of dysplasia in our patient population with the majority of patients positive for low-risk HPV subtypes indicating that high-risk HPV subtypes do not predispose laryngeal papilloma patients to dysplasia.

Persisters and nonpersisters: Identifying the characteristics of who stays and who leaves from adult literacy interventions.

Adult literacy programs are characterized by high attrition rates. Rigorous exploration of student persistence in adult reading classes is lacking. This study was an attempt to understand the profiles of adults who completed reading classes compared to a group of adults who made it to the midpoint and a group of adults who did not make it to the midpoint. Students were offered 100 hours of instruction. Of the 395 students who attended the first day of class, only 198 completed the program. Results indicated that English language status, age, some reading related skills, class assignment, avoidance of reading, previous adult education experience, and Women, Infants, and Children (WIC) benefit receipt variables significantly predicted persistence. The significance of some of these predictors varied based on analyzing midpoint completion or full completion. To further explore the characteristics of the sample, the most representative participants were selected from the group that did not make it to midpoint and from the group that completed the program. Results indicated that the most representative members of these two groups differed in English language status, gender, age, some reading related skills, and information access.

Voice outcomes from subligamentous cordectomy for early glottic cancer.

OBJECTIVES: We evaluated the voice and vocal fold pliability outcomes of European Laryngological Society (ELS) deep type I (subepithelial) and type II (subligamentous) cordectomies for early glottic cancer. METHODS: We reviewed the medical records of patients with glottic carcinoma at a tertiary care medical center between 2005 and 2011. Their procedures were stratified into ELS type I and ELS type II cordectomies. The data recorded included age, gender, tumor stage, recurrence, patient-assessed voice-related quality of life, perceptual voice evaluation, and stroboscopy. RESULTS: Four patients were identified as having subepithelial cordectomy, and 13 as having subligamentous cordectomy. The average preoperative and postoperative voice-related quality of life scores were 65 and 74 for the ELS I cohort and 64 and 95 for the ELS II group. The preoperative and postoperative perceptual voice evaluation scores were 56 and 35 for the ELS I cohort and 45 and 21 for the ELS II cohort. The ELS I cohort had a moderately to severely reduced mucosal wave, with 75% of patients demonstrating glottic insufficiency, whereas the ELS II cohort had a mildly to moderately reduced mucosal wave, with 8% of patients demonstrating glottic insufficiency. The survival outcomes were the same. CONCLUSIONS: Patients who underwent subligamentous excision of early glottic cancer had significantly improved postoperative voice and stroboscopy scores. This finding suggests that if tumor resection reaches the vocal ligament, and minimal superficial lamina propria can be preserved, subligamentous cordectomy should be performed.

Differences in head and neck cancer risk perception between smoking and nonsmoking NASCAR attendees.

OBJECTIVE: Although research has documented a difference in cancer risk perception between smokers and nonsmokers, this has not been specifically documented for head and neck cancer. The aim of this study was to determine differences in risk perception for head and neck cancer between smokers and nonsmokers in an at-risk population. STUDY DESIGN: A cross-sectional survey was administered. SETTING: Community-based head and neck cancer screenings. SUBJECTS AND METHODS: Participants completed a 28-item questionnaire assessing sociodemographic information, smoking status, and risk perception of head and neck cancer. RESULTS: In total, 507 participants completed the questionnaire. Multivariate analysis of variance (MANCOVA) using dependent variables related to risk perception of head and neck cancer evidenced a significant main effect that smokers (mean [SD], 1.10 [0.07]) worried about head and neck cancer significantly more than nonsmokers (0.64 [0.06]), F(1, 459) = 26.97, P < .001, η(2) = .06, and nonsmokers (2.70 [0.05]) believed head and neck cancer was significantly more dangerous than did smokers (2.53 [0.06]), F(1, 459) = 5.90, P = .015, η(2) = .01. CONCLUSION: Findings indicated differences in perception of risk for head and neck cancer between smokers and nonsmokers. By gaining a better understanding of the psychosocial factors related to perceived risk of head and neck cancer, otolaryngologists and health care providers may better tailor interventions aimed at increasing awareness of cancer risk and promoting cessation.

The impact of a community-based oral, head and neck cancer screening for reducing tobacco consumption.

OBJECTIVE: Examine the usefulness of large-scale community-based head and neck cancer screening for reducing tobacco use in an at-risk population. Questions answered: (1) Is participating in a community-based head and neck cancer screening related to a reduction in tobacco usage? (2) Do differing factors between participants predict behavior change? STUDY DESIGN: Survey based with a longitudinal follow-up component. SETTING: Atlanta Motor Speedway during a National Association of Stock Car Auto Racing (NASCAR) race event. SUBJECTS AND METHODS: Recruited NASCAR fans (n = 620). Initial screening and 11-question survey for 6-month telephone follow-up. RESULTS: One hundred fifty-six participants (25%) required medical follow-up. Chi-square analysis indicated a significantly higher proportion of smokers (13%) evidenced positive findings compared to nonsmokers (8%) or past smokers (6%). Kruskal-Wallis analysis followed by Dunn's multiple comparison post hoc test indicated smokers were from a significantly lower socioeconomic status background compared to nonsmokers. Analysis of variance indicated contacted participants reported smoking significantly fewer cigarettes per day 6 months postscreening compared to the number of cigarettes smoked at the baseline. Forty-four (59%) participants reported reducing the number of cigarettes smoked per day, and 11 participants reported quitting smoking. CONCLUSION: The authors have demonstrated that large-scale community-based head and neck cancer screenings can be effectively implemented in nonmedical venues. This study demonstrated that targeting education for reduction of risk factors in the NASCAR population positively affected tobacco cessation.

Results of a large-scale head and neck cancer screening of an at-risk population.

OBJECTIVE/HYPOTHESIS: To determine whether a community-based head and neck cancer screening could be an effective method to detect positive findings of head and neck cancer in at-risk populations. STUDY DESIGN: Survey-based study with a nonexperimental intervention component. METHODS: Five hundred sixty-eight adults were screened for oral and laryngeal cancers by otolaryngologists and oral and maxillofacial surgeons during three National Association of Stock Car Auto Racing race weekend events. A prescreening survey collected demographic information, relevant medical history, and information regarding risk factors for head and neck cancers, including current or past tobacco use, alcohol consumption, and chemical exposures. Signs and symptoms of head and neck cancer were documented during the screening. RESULTS: Forty-three percent of participants with a history of smoking had abnormal findings. A Pearson chi-square indicated that the proportion of males who evidenced positive findings was significantly (P<0.05) higher than the proportion of females who evidenced positive findings. For every pack of cigarettes smoked per day, an individual was 1.95 times more likely to evidence abnormal findings even after controlling for alcohol use, family history of cancer, personal history of head and neck cancers, sex, age, and occupation. CONCLUSIONS: This study is the first to document the results of a large-scale head and neck cancer screening of a population of people known to be at risk of head and neck cancers. The study demonstrates the feasibility of developing and implementing large-scale community-based head and neck cancer screenings, as are often seen in the early diagnosis and education of signs, symptoms, and risks for other cancers.

Differences in temporal variables between voice therapy completers and dropouts.

OBJECTIVES: The aim of this study was to examine temporal variables thought to be associated with voice therapy completion. STUDY DESIGN: Retrospective chart review of 197 cases (120 dropouts and 77 completers) seen at two voice centers. METHODS: Cases included males and females aged 15-90 years presenting with a chief complaint of dysphonia who were referred by an otolaryngologist to a speech-language pathologist for voice therapy. Cases were analyzed from the date of physician referral through the final therapy session. The dependent variable was completion of voice therapy. Independent variables included selected temporal variables related to the timing, frequency, and duration of voice therapy. A binary logistic regression was performed to evaluate the relationship between the dependent variable and the temporal variables. Differences between groups were assessed with independent t tests and post hoc analysis. RESULTS: There were significant differences between groups for the number of sessions attended and the wait time between otolaryngology referral and speech-language pathology evaluation, which were also the strongest predictors of therapy completion. CONCLUSIONS: There was a strong relationship found between selected temporal variables and therapy completion. Future research directions will examine methods to use these findings to effect a reduction in voice therapy dropout.

Self-concept development and measurement in children with mild intellectual disabilities.

OBJECTIVE: Using a multi-trait-multi-method technique, self-concept was analysed as a function of chronological age in children with mild intellectual disabilities. Also, relations between reading achievement and self-concept were measured. METHODS: Participants were assessed on the Woodcock Reading Mastery Test-Revised, the Pictorial Scale of Perceived Competence and Social Acceptance and the Self-Description Questionnaire I--Individual Administration. RESULTS: A median split was run to divide participants into younger and older groups; older participants evidenced coefficients that revealed more multidimensionality, stability and discriminant validity. Also, a significant canonical correlation was found between the Harter Pictorial Scale at Time 1 and WRMT-R at Time 2, chi(2)(8) = 17.99, r = 0.62, p = 0.02. CONCLUSION: As a whole, these results suggest that children with intellectual disabilities evince self-concept development similar to what would be expected in typically-developing children.

The relationship between phonological processing skills and word and nonword identification performance in children with mild intellectual disabilities.

Word and nonword identification skills were examined in a sample of 80 elementary school age students with mild intellectual disabilities and mixed etiologies who were described as struggling to learn to read by their teachers. Performance on measures of receptive and expressive vocabulary, measures of phonological awareness, and measures of word and nonword identification were included for analyses. Hierarchical regression analyses indicated that, after controlling for chronological age and vocabulary knowledge, phonological processing accounted for a large and significant amount of unique variance of both word and nonword identification. In addition, the pattern of results found in this study is similar to that obtained with typically developing learners. As with typically developing children, measures of phonological awareness were significantly correlated with measures of both reading achievement and vocabulary knowledge.

The relationship between different measures of oral reading fluency and reading comprehension in second-grade students who evidence different oral reading fluency difficulties.

PURPOSE: The purpose of this study was to examine whether different measures of oral reading fluency relate differentially to reading comprehension performance in two samples of second-grade students: (a) students who evidenced difficulties with nonsense-word oral reading fluency, real-word oral reading fluency, and oral reading fluency of connected text (ORFD), and (b) students who evidenced difficulties only with oral reading fluency of connected text (CTD). METHOD: Participants (ORFD, n = 146 and CTD, n = 949) were second-grade students who were recruited for participation in different reading intervention studies. Data analyzed were from measures of nonsense-word oral reading fluency, real-word oral reading fluency, oral reading fluency of connected text, and reading comprehension that were collected at the pre-intervention time point. RESULTS: Correlational and path analyses indicated that real-word oral reading fluency was the strongest predictor of reading comprehension performance in both samples and across average and poor reading comprehension abilities. CONCLUSION: Results of this study indicate that real-word oral reading fluency was the strongest predictor of reading comprehension and suggest that real-word oral reading fluency may be an efficient method for identifying potential reading comprehension difficulties.

Proximal pharyngeal reflux correlates with increasing severity of lingual tonsil hypertrophy.

OBJECTIVE: To determine if degree of lingual tonsil hypertrophy (LTH) correlates with pharyngeal reflux. DESIGN: Prospective. METHODS: Patients with flexible laryngoscopic evidence of LTH were included. Degree of LTH was graded mild, moderate, or severe by two otolaryngologists blinded to pH study results. Three-sensor pH study results were correlated to LTH grade. RESULTS: Nineteen patients were included (five with mild LTH, eight with moderate LTH, and six with severe LTH). Nasopharyngeal reflux (NPR) events

Phonological Awareness and Rapid Naming Skills of Children with Reading Disabilities and Children with Reading Disabilities Who Are At Risk for Mathematics Difficulties.

Limited research has examined the skills of children with a reading disability (RD) and children with RD and a mathematics disability (MD). Even less research has examined the phonological awareness (PA) and rapid automatized naming (RAN) skills in these two groups of children and how these skills relate to reading and math achievement. Additionally, various classification criteria are frequently implemented to classify children with MD. The purpose of this study, therefore, was to examine the PA and RAN skills in children who met different criteria for RD only and children with RD who are at-risk for mathematics difficulties (MDR). Participants were 114 second or third grade students with RD from public elementary schools in three large metropolitan areas. Students were classified as at-risk for mathematics difficulties utilizing a 25th percentile cutoff and a 15th percentile cutoff as assessed by the KeyMath-Revised Test (Connolly, 1988). A series of PA and RAN measures were administered along with a range of reading and mathematics measures. Hierarchical regression analyses indicated that children with RD only evidenced a different pattern of results compared to children with RD + MDR. Additionally, using a more stringent criterion to classify children at-risk for mathematics difficulties resulted in a differential pattern of results when compared to a less stringent classification criterion.

The relationship among receptive and expressive vocabulary, listening comprehension, pre-reading skills, word identification skills, and reading comprehension by children with reading disabilities.

PURPOSE: Some researchers (F. R. Vellutino, F. M. Scanlon, & M. S. Tanzman, 1994) have argued that the different domains comprising language (e.g., phonology, semantics, and grammar) may influence reading development in a differential manner and at different developmental periods. The purpose of this study was to examine proposed causal relationships among different linguistic subsystems and different measures of reading achievement in a group of children with reading disabilities. METHODS: Participants were 279 students in 2nd to 3rd grade who met research criteria for reading disability. Of those students, 108 were girls and 171 were boys. In terms of heritage, 135 were African and 144 were Caucasian. Measures assessing pre-reading skills, word identification, reading comprehension, and general oral language skills were administered. RESULTS: Structural equation modeling analyses indicated receptive and expressive vocabulary knowledge was independently related to pre-reading skills. Additionally, expressive vocabulary knowledge and listening comprehension skills were found to be independently related to word identification abilities. CONCLUSION: Results are consistent with previous research indicating that oral language skills are related to reading achievement (e.g., A. Olofsson & J. Niedersoe, 1999; H. S. Scarborough, 1990). Results from this study suggest that receptive and expressive vocabulary knowledge influence pre-reading skills in differential ways. Further, results suggest that expressive vocabulary knowledge and listening comprehension skills facilitate word identification skills.

Gastroesophageal reflux and laryngopharyngeal reflux in patients with sleep-disordered breathing.

OBJECTIVE: To assess the relationship of gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR) with obstructive sleep apnea (OSA). PATIENTS AND METHODS: Thirty-seven sleep-disordered breathing (SDB) patients underwent polysomnography (PSG) and dual-channel pH probe testing. LPR was defined as greater than 6.9 proximal reflux episodes or reflux area index (RAI) greater than 6.3. GER was defined as greater than 4% of time below pH 4.0. RESULTS: OSA was present in 28 patients. Twenty-three patients had LPR (66.7% of snorers, 60.7% of OSA patients). Twenty-one patients had GER (33.3% of snorers, 64.3% of OSA patients). Body mass index (BMI) correlated positively with respiratory disturbance index (RDI) (r = 0.67, P < 0.001). BMI did not correlate with pH probe parameters. OSA presence/severity did not correlate with LPR or GER. Supine LPR and GER events did not correlate with OSA presence/severity. CONCLUSION: Gastric acid reflux is prevalent in SDB patients. Direct correlations between reflux and PSG parameters were not identified. EBM RATING: B-2b.

Association of nasopharyngeal and laryngopharyngeal reflux with postnasal drip symptomatology in patients with and without rhinosinusitis.

BACKGROUND: Patients often report postnasal drip (PND), but objective rhinosinusitis and allergy findings are frequently absent. In this study, we evaluate the association between PND and pharyngeal reflux. METHODS: Sixty-eight participants underwent 24-hour pH testing, including chronic rhinosinusitis (CRS) patients persistently symptomatic after endoscopic sinus surgery, CRS patients successfully treated by endoscopic sinus surgery, and volunteers without a CRS history. The pH probes contained nasopharyngeal (NP), laryngopharyngeal (LP), and distal esophageal sensors. Participants completed the Sinonasal Outcome Test-20 (SNOT-20) and Modified Reflux Symptom Index (MRSI) questionnaires. Survey items addressing PND symptomatology were compared with NP reflux (NPR) below pH 4 and pH 5 (defined as > or = 1 event), and LP reflux (LPR; defined as > or = 7 events or reflux area index > 6.3). RESULTS: Pearson analyses revealed a positive correlation of r = 0.87 between SNOT-20 and MRSI PND items. For NPR < pH 4, no significant difference existed between participants with and without reflux on the SNOT-20 or MRSI (p > 0.05). However, for NPR < pH 5, reflux-positive participants exhibited significantly more PND symptoms on the SNOT-20 (p = 0.030) and the MRSI (p = 0.018) compared with participants without reflux. Finally, participants with LPR had significantly more PND symptomatology on the SNOT-20 (p = 0.010) versus those without LPR. A borderline significant difference existed on the MRSI PND item between participants positive and negative for LPR (p = 0.055). CONCLUSION: Objective evidence of NPR and LPR exists in patients reporting PND. Reflux treatment may reduce PND complaints.

Evaluation of postoperative pain after sinonasal surgery.

BACKGROUND: Pain after sinonasal surgery concerns both patients and surgeons. Factors affecting sinonasal postoperative pain have not been examined extensively. METHODS: Using a prospective survey design, sinonasal surgery patients evaluated postoperative pain (on a scale of 0-10), pain location, and medication use. RESULTS: One hundred twenty-seven patients consented to participate. One hundred fifteen patients returned surveys, with 100 patients appropriate for analysis over the 6-day postoperative period. Pain score and medication use were evaluated with respect to sex, primary/revision case, nasal packing, and other factors. Repeated measures analysis of variance and chi-square analysis were conducted (p < 0.05). Pain ratings and analgesic use declined significantly over the postoperative period (p < 0.05). Mean pain score on postoperative day (POD) 1 was 3.61 and on POD 6 was 1.72. Mean medication use was 1.37 tablets on POD 1 and 0.55 tablets on POD 6. Additionally, a significant interaction existed, such that narcotic medication use declined from 1.91 tablets on POD 1 to 0.52 tablets on POD 6, whereas nonnarcotic medication use remained steady (p < 0.05). Periorbital pain was most frequent (46.3%), with unilateral facial pain reported least (4.1%). A significant difference existed for distribution of pain location (p < 0.05). Finally, the difference in pain rating between primary and revision procedure for women (0.65) was less than for men (1.12); this interaction was significant (p < 0.05). CONCLUSION: Multiple patient and operative factors affect pain rating and medication use after sinonasal surgery. Generally, pain level should be low with little analgesic use postoperatively.

The woodcock reading mastery test: impact of normative changes.

This study examined the magnitude of differences in standard scores, convergent validity, and concurrent validity when an individual's performance was gauged using the revised and the normative update (Woodcock, 1998) editions of the Woodcock Reading Mastery Test in which the actual test items remained identical but norms have been updated. From three metropolitan areas, 899 first to third grade students referred by their teachers for a reading intervention program participated. Results showed the inverse Flynn effect, indicating systematic inflation averaging 5 to 9 standard score points, regardless of gender, IQ, city site, or ethnicity, when calculated using the updated norms. Inflation was greater at lower raw score levels. Implications for using the updated norms for identifying children with reading disabilities and changing norms during an ongoing study are discussed.

Association of radiological evidence of frontal sinus disease with the presence of frontal pain.

BACKGROUND: Rhinosinusitis is a common cause of frontal pain. We evaluated the relationship between frontal pain and the type and degree of frontal sinus disease in chronic rhinosinusitis (CRS) patients. METHODS: Inclusion criteria were presence of frontal sinusitis or frontal recess obstruction on computed tomography scan. Office notes and operative reports were reviewed to determine the presence and location of frontal pain and categorization of sinus disease. RESULTS: Two-hundred seven patients were identified with frontal recess obstruction and/or frontal sinus disease. Thirty-one of 37 frontal mucocele patients (84%) had frontal pain. Twenty of 70 polyp patients (29%) had frontal pain, with only 7 of 38 patients (18%) with complete frontal opacification having pain. In patients with CRS without polyps or mucocele, 59 of 100 (59%) had frontal pain, with 21 of 38 (55%) with complete opacification having pain. This difference between the distribution of frontal pain was significant (p < 0.005) among the mucocele, polyp, and nonpolypoid CRS groups. Additionally, among nonmucocele CRS groups exhibiting complete opacification, there was a significant difference in proportion of patients exhibiting frontal pain (p < 0.005). When the nonmucocele groups (i.e., polypoid and nonpolypoid CRS patients) were combined and stratified for disease extent, a difference in the distribution of frontal pain was found (p < 0.025), with the mild-to-moderate thickening group showing the highest proportion of pain. CONCLUSION: Frontal pain was more common in nonpolypoid CRS patients than in polyp patients. Furthermore, in nonmucocele CRS, patients with mild-to-moderate thickening exhibited more frontal pain.