Sex-Related Variability in the Perception of Symptoms Associated With Common Otolaryngologic Complaints

Objective: To assess the differences in the symptoms associated with common otolaryngology complaints between male and female patients. Methods: Between June 2020 and July 2023, a multi-institutional cross-sectional study was performed at six tertiary academic otolaryngology practices using semantics-based questionnaires to assess the symptoms patients associate with the complaints of sinus infection, reflux, congestion, and dizziness. Patients selected symptoms from lists of proposed terms to describe the various conditions. The primary outcome measure was sex-related differences in respondent symptom selection. Results: Four separate questionnaires were completed by a total of 1495 patients (46.0% male, 54.0% female). Female patients more often described sinus infection using pain-related symptoms (difference 8.8%; 95% CI, 2.8% to 14.8%) and systemic-related symptoms (difference 10.2%; 95% CI, 2.3% to 18.2%), reflux using pain-related symptoms (difference 18.3%; 95% CI, 3.6% to 41.7%) and sensory-related symptoms (difference 13.1%; 95% CI, 2.5% to 23.7%), and dizziness using vision-related symptoms (13.2%; 95% CI, 1.9% to 24.6%) compared to male patients. Female patients selected individual symptoms within the pain-related domain more often than male patients to describe congestion. Few differences per questionnaire were identified based on geographic location. Conclusion: Sex-related differences exist in how patients describe common otolaryngologic complaints. Women more commonly associate pain-related symptoms with sinus infection and reflux, sensory-related symptoms with reflux, and vision-related symptoms with dizziness. A more nuanced understanding of how men and women describe complaints may lead to more effective, patient-centered care within otolaryngology. Level of Evidence: 4.