Reliability and Validity of the Arabic Version of the NOSE-Perf Scale

Objectives: To assess the psychometric validity of the Arabic adaptation of the nasal obstruction symptom evaluation–perforation (NOSE-Perf) scale. To assess how reliable and valid the Arabic adaptation of the NOSE-Perf questionnaire is. Patients with septal perforations, particularly Arabic speakers, lack validated self-assessment tools for subjective symptom evaluation. Methods: Conducted between May 2024 and June 2025, the study included 100 participants—20 patients with septal perforation and 80 controls. Participants filled out a questionnaire consisting of demographic data as well as the Arabic forms of the Sino-Nasal Outcome Test-22 (SNOT-22), NOSE, and NOSE-Perf scales. Cronbach's alpha was applied to determine internal consistency, and the intraclass correlation coefficient (ICC) was utilized to verify test–retest reliability. Discriminative validity was evaluated by comparing score differences, while concurrent validity was analyzed through correlations with the NOSE and SNOT-22 scales. Results: Strong correlations were observed between the NOSE-Perf and the established NOSE (r = 0.920, p < 0.001) and SNOT-22 (r = 0.885, p < 0.001) measures, confirming the scale's concurrent validity. Discriminative validity was evident: NOSE-Perf scores were significantly higher in cases (29.8 ± 9.48) than controls (5.76 ± 8.10, p < 0.001; AUC = 0.856). NOSE scores also differed (cases: 68.1 ± 26.1; controls: 9.44 ± 21.9; p < 0.001; AUC = 0.931). SNOT-22 scores were 57.1 ± 24.2 in cases and 18.0 ± 18.4 in controls (p < 0.001; AUC = 0.32). Conclusion: The Arabic adaptation of the NOSE-Perf questionnaire exhibited reliability and validity as a tool for assessing subjective symptoms among individuals experiencing septal perforation.