Setting;
1072 patients with chronic rhino sinusitis were subjected to demographic data, symptoms of CRS((persist nasal discharge, nasal obstruction, headache or facial pain , anosmia or other related symptoms such as ear infection, low grade fever, snoring, chronic cough ), Complete ENT examination including cranial nerves examinations , Nasal endoscopic examination ,Computed tomography PNS and nasal swab for culture & sensitivity were included into our study .
All the patients were subjected to a validated questionnaire which developed in Arabic language and reviewed as expected in this area. The questionnaire divided into four sections which begin with questions about socio-demographic characteristics of participants’ age group, gender, residency and level of education. The questionnaire also, include questions about the specific symptoms of chronic rhino-sinusitis according to the symptom-based definition of CRS provided in European Position Paper on Rhino sinusitis and Nasal Polyps (EP3OS) and has been validated and is suitable for use in epidemiological and clinical research with the presence of more than two of the symptoms : 1- nasal blockage 2- nasal discharge 3- facial pain/pressure or 4- reduction in smell, for more than three months in the last year with at least one of symptoms being number 1 or 2. (4) The new definition of (EP3OS) added 5- self reported doctor diagnosed CRS. A common grading tool will be used to assess the quality of life by the 22-item Sinonasal Outcomes Test (SNOT-22) which is disease specific stratified as mild (8-20), moderate ( >20-50) and severe (>50).(15) The risk of depression screened by PHQ-2 with Lost productivity was assessed by asking participants how many days of work and/or school they missed in the last three months because of CRS.(16)
All patients were required to complete a questionnaire assessing their subjective nasal symptoms using a visual analogue scale (VAS), with 0 indicating no symptoms and10 indicating severe and/or constant symptoms.
Stress was analyzed using the Kessler Psychological Distress Scale to determine the effect of stress on severity of allergic rhinitis (10 items representing five psychological distress traits were assessed with a five-point scale).(17)