Risk factors for recurrence of chronic rhinosinusitis with nasal polyps after endoscopic sinus surgery: A retrospective study

OBJECTIVES

To assess the pathophysiological factors leading to chronic rhinosinusitis (CRS) recurrence with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS) and compare the clinical and imaging findings between both groups.

METHODS

A retrospective study was carried out at a tertiary hospital. Patients with recurrent nasal polyps were compared to those with no recurrence by demographics, risk factors, anatomical abnormalities, clinical features, and Lund-Mackey (LM) scores. Both groups were followed up for 24 months after the primary surgery to detect recurrence.

RESULTS

Among the 134 patients who underwent ESS for CRSwNP, 69 patients were in the recurrence group and 65 in the non-recurrence group. No significant difference was found in demographics, comorbidities, and anatomical abnormalities between both groups. However, asthma was more prevalent in the recurrence group (73.9% vs. 29.2%; p<0.01). All clinical features were similar between both groups. However, the recurrence group had more patients with bilateral polyps than non-recurrence (95.7% vs. 80%; p<0.01). We found that 26.1% (n=18) of the 69 patients with recurrence needed revision surgery. Smoking rates were significantly different between reoperated vs. non-reoperated patients (16.7% (3/18) vs. 2% (1/51); p=0.02), and the extent of primary ESS was different between them.

CONCLUSION

Asthma is a significant risk factor for CRS recurrence. Furthermore, smoking and inadequate primary surgery increase the chance of revision surgery in case of recurrence.

The Prevalence and Impact of Allergic Rhinitis on Academic Performance and Quality of Life Among Medical Students in Saudi Arabia

BACKGROUND

Allergic Rhinitis (AR) has a negative impact on both patients and society. Our study aims to assess the impact of allergic rhinitis on the academic performance and quality of life of medical students in Saudi Arabia.

METHODOLOGY

A cross-sectional survey targeted medical students in Saudi Arabia; a total of 851 students were included. The survey included questions on sociodemographic characteristics, academic year and GPA, Score for Allergic Rhinitis (SFAR), and Rhino-sinusitis Disability Index (RSDI).

RESULTS

We found that about 340 students (39.9%) had AR. The RSDI for students with AR was 34.9 ‡ 28.8, significantly higher than those with no AR (17.0 + 23.6),p<0.001. The relationship between AR and students* GPAs showed that those who had not experienced AR significantly had comparatively good PAs and above. In contrast, those who had experienced AR had poor GPAs (p<0.001). Similarly, students with AR had significantly missed classes more than those who had not experienced AR (p<0.001).

CONCLUSION

The study showed that Allergic rhinitis negatively impacted Medical Students' academic performance and quality of life. It impacts wakefulness, and sleeping patterns can have a negative impact on academic performance.

Public Knowledge, Attitudes, and Practices Regarding Brucellosis in Taif City, Saudi Arabia

BACKGROUND

Brucellosis is a serious zoonotic infectious disease. Humans contract the disease by coming into contact with infected animals or their products. In Saudi Arabia, brucellosis is considered to be an endemic disease, with an annual incidence of 15.34 per 100,000 population from 2003 to 2018. Because of the devastating consequences for human health, raising awareness is an essential component in preventing brucellosis. Our study aims to assess the knowledge, awareness, and attitudes regarding brucellosis among the residents of Taif City, Saudi Arabia.

METHODS

A descriptive, cross-sectional survey conducted in June-October 2022 targeted the population of Taif City, Saudi Arabia. The data were collected by an online questionnaire, which included questions on sociodemographic characteristics, awareness regarding brucellosis, behavior and attitude toward animals, and consuming animal-based products.

RESULTS

A total of 743 participants were included. The participants were 18-70 years old, 63.4% were females, and 79.4% had a university education. Only 450 participants answered yes to the first question: "Do you know about brucellosis or have you heard about it?" Therefore, they were asked to answer knowledge questions. It was found that out of 450 participants, 46.9% demonstrated a "poor" knowledge level. Participants aged 26-55 years old demonstrated significantly more "good" knowledge than the other age groups (p = 0.001). Males demonstrated significantly more "good" knowledge (30.6%) than females (14.9%) (p < 0.001). The practices and attitudes of animal breeder participants (16.2%) were satisfactory because more than half of them did not participate in the birth of animals (53.4%), 50.7% did not participate in the birth with abortion, and approximately 61% used gloves when taking care of animals. The practices were unsatisfactory because 53.4% of the participants reported that they "always" eat the meat of animals they keep, and 64.4% reported that they personally slaughter sheep or cows from the herd.

CONCLUSION

Our study showed that most of the participants were aware of brucellosis; however, at the same time, the knowledge level regarding brucellosis was not satisfactory.

A Comparison of Symptom Improvement and Outcomes After Septoplasty Alone Versus Septoplasty With Turbinoplasty

Background Various causes can lead to nasal obstruction, with the most frequent anatomical cause being deviated nasal septum. It seriously affects patients' quality of life. As a result, septoplasty is performed to enhance the nasal airways. This study aimed to compare the improvement of nasal symptoms following septoplasty with or without turbinoplasty and evaluate the surgical outcomes in both different groups. Methodology A retrospective study was conducted at a tertiary hospital among patients who had undergone septoplasty with or without turbinoplasty between 2020 and 2022. Data regarding demographics, clinical features, surgical data, and complications were collected from patient files. The Nasal Obstruction Symptom Evaluation (NOSE) scale score was assessed through structured interviews. Results In our analysis of 209 patients who underwent surgery for deviated nasal septum, septoplasty was done in 110 (52.6%) patients, whereas the remaining 99 (47.4%) underwent septoplasty with turbinoplasty. The mean NOSE score was found to be 32.94 ± 35.67%. Patients who underwent septoplasty alone significantly showed higher mean scores (56.36 ± 34.62%) compared to those who underwent septoplasty with turbinoplasty (11.14 ± 18.93%) (p < 0.001). The long-term complications showed revision surgery was done in 13 patients, which was comparatively more often done in patients who underwent a septoplasty. Other long-term complications were found to be significantly higher in patients who underwent septoplasty (76.9%) compared to those who underwent septoplasty with turbinoplasty (23.1%). Conclusions Patients who underwent additional turbinoplasty experienced an improvement in nasal symptoms than those who underwent septoplasty alone. In addition, more long-term complications were noted in patients who underwent septoplasty alone.

Prevalence of and Factors Associated With Eustachian Tube Dysfunction Among the Public in Taif, Saudi Arabia

Background

The eustachian tube is a tubular structure connecting the middle ear cavity with the nasopharynx, providing ventilation and pressure equalization in the middle ear, mucociliary clearance, and preventing the reflux of sound and fluid from the nasopharynx. Therefore, any kind of deficiency in this tube will lead to eustachian tube dysfunction (ETD).

Aim

This study aims to evaluate the prevalence and associated factors of ETD in the Taif public.

Materials and methods

A descriptive cross-sectional survey was conducted among the public in Taif, Saudi Arabia and it was done during the period between September 7 and September 28, 2021. A predesigned online questionnaire in the Arabic language was used to collect the data. The questionnaire contained three main parts. The first one included demographic questions, the second risk factors, and the third manifestations of ETD. The questionnaire was initiated after a literature review of similar articles and after experts' consultation for validity and reliability.

Results

A total of 693 participants completed the study questionnaire. The exact 546 (78.8%) participants were females and 671 (96.8%) were Saudi. The exact 122 (61%) participants among those who had ETD or hearing loss reported improvement in their symptoms after moving to another city below sea level. The exact 146 (21.1%) participants had ETD while 547 (78.9%) had reported normal function. ETD was detected among 69.2% of those who were previously diagnosed with ETD versus 20.1% of others (P=0.001). Participants with a family history of hearing loss showed a nearly doubled risk for having ETD (OR=1.98; 95% CI: 1.33-2.94) and smokers had nearly the same doubled likelihood(OR=1.83; 95% CI: 1.01-3.48).

Conclusion

In conclusion, our study revealed a slightly high prevalence of ETD and hearing loss among the public in Taif, Saudi Arabia, and the factors associated with ETD.