ACKNOWLEDGEMENT  The authors would like to extend sincere gratitude to Samy ELWANY, MD FACS, Professor of Otolaryngology, Alexandria University, Egypt, whose help and valuable guidance provided indispensable support to the accomplishment of this study. Professor ELWANY’s consent for acknowledgement was obtained. CONSENT FOR PUBLICATION  Not applicable AVAILABILITY OF DATA AND MATERIALS  The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. ETHICAL APPROVAL AND CONSENT TO PARTICIPATE  The study was approved by Research Ethics Committee-Benha Faculty of Medicine (RECFOMBU), and was performed in accordance with the ethical standards of the Declaration of Helsinki. All patients and/or their surrogates were informed, and written consent to participate in the trial was obtained prior to enrolment.  MoHP No.: 0018122017  Certificate No.: 1017  Study No.: Ms.24.6.2020 NUMBER OF PAGES AND WORD COUNT  Total number of pages: 30  Word count for Abstract: 250  Word count for Text: 3881