Background/Objectives: Eustachian Tube Dysfunction (ETD) is a prevalent condition affecting middle ear pressure regulation, yet nationwide epidemiological data in Saudi Arabia remain limited. This study aimed to assess the prevalence of ETD and identify its associated factors among Saudi adults using a validated screening tool. Methods: A nationwide cross-sectional study was conducted between June 2024 and March 2025 among 1124 Saudi adults (aged ≥ 18 years) across five geographic regions. ETD was assessed using the validated Arabic version of the seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7), with scores ≥ 14.5 indicating dysfunction. Data on demographic, anthropometric, clinical, and lifestyle characteristics were collected via an online questionnaire. Multiple linear regression analysis identified independent predictors of ETDQ-7 scores, with statistical significance set at p < 0.05. Results: The prevalence of ETD was 33.9% (95% CI: 31.1–36.8%), substantially higher than the 7% self-reported rate. Of affected participants, 29.6% had mild-to-moderate ETD and 4.3% had severe dysfunction. Multivariable regression analysis identified four significant independent predictors: higher body mass index (BMI) (β = 0.08; 95% CI: 0.03–0.16; p = 0.049), family history of hearing loss (β = 1.87; 95% CI: 0.90–2.83; p < 0.001), prior bariatric bypass surgery (β = 14.37; 95% CI: 3.33–25.41; p = 0.011), and allergies (β = 3.19; 95% CI: 2.30–4.07; p < 0.001). No significant associations were found with demographic factors, smoking, or other comorbidities. Conclusions: ETD affects approximately one-third of Saudi adults, with significant underdiagnosis. Obesity, genetic predisposition, bariatric surgery, and allergic conditions represent key modifiable and non-modifiable risk factors. These findings support implementing routine ETDQ-7 screening in primary care and targeted interventions for high-risk populations.

Background: Recurrent adenotonsillitis is a frequent pediatric condition with complications affecting sleep, growth, hearing, and behavior. Parental awareness is essential for early identification and timely intervention. Aim: This study aimed to assess parental knowledge and awareness of recurrent adenotonsillitis complications and its surgical management among parents in the Jazan region, Saudi Arabia. Methods: A cross-sectional survey was conducted among parents residing in the Jazan region who had at least one child aged 1–14 years. A validated self-administered questionnaire assessed sociodemographic characteristics and knowledge of adenotonsillar disease and surgery. Descriptive and inferential statistical analyses were performed using SPSS version 26, with significance set at p < 0.05. Results: Out of 448 respondents, 311 met inclusion criteria. Most were female (59%), Saudi (97%), and had university-level education (72%). About 57% of parents showed good knowledge based on scoring above the mean. Awareness was higher regarding symptoms like snoring (66%), sleep apnea (67%), and voice changes (75%). However, fewer parents recognized complications such as pulmonary hypertension (28%), GERD (32%), or dental issues (31%). Nearly half (49%) acknowledged weight loss as a possible consequence of chronic infections, and 58% agreed neck swelling could be a sign. Regarding surgery, 44% believed immunity might weaken post-adenotonsillectomy, and 47% identified bleeding as the most common complication. Only 40% were aware of adenoid regrowth. Age over 40 ( p < 0.001) and positive family history ( p = 0.001) were significantly associated with higher knowledge. Conclusion: While parental awareness of some aspects of adenotonsillar complications is adequate, notable gaps remain, particularly concerning long-term and systemic effects. Targeted health education campaigns are essential to bridge these gaps and support better pediatric health outcomes.