CLINICAL QUESTION
What are the objective patterns of olfactory impairment in patients with uncontrolled chronic rhinosinusitis (CRS) disease according to Sniffin’ Sticks testing?
Explore This Issue
May 2024BOTTOM LINE
Patients with uncontrolled CRS demonstrate distinct patterns of olfactory impairment, and a reduced olfactory threshold is highly associated with uncontrolled CRS.
BACKGROUND: The updated 2020 European Position Paper (EPOS) on Rhinosinusitis and Nasal Polyps treated self-reported olfactory dysfunction as an important component of CRS disease control. A reduced olfactory threshold has been associated with uncontrolled CRS. However, no studies have explored patterns of olfactory impairment with objective testing among patients with uncontrolled CRS.
STUDY DESIGN: Prospective study.
SETTING: Department of Otolaryngo-logy-Head and Neck Surgery, Xuanwu Hospital Capital Medical University, Beijing, People’s Republic of China.
SYNOPSIS: From December 2020 to December 2021, researchers recruited 79 adult patients (52 males, mean age 43.1 years) who had received a diagnosis of CRS. All patients were assessed for disease control based on EPOS criteria that combined symptoms, endoscopy findings, and rescue treatment needs. Sniffin’ Sticks test scores, olfactory cleft computed tomography (CT) scores, olfactory cleft endoscopy scale (OCES), questionnaire of olfactory disorders negative statements (QOS-NS), and sinonasal outcome test-22 (SNOT-22) were obtained. Patients were divided into uncontrolled CRS (>2 criteria met, n = 21) and controlled CRS (<2 criteria met, n = 58) groups. Findings showed odor threshold, odor identification, and thresholds-discrimination-identification scores were significantly lower in patients with uncontrolled CRS. Further, patients with uncontrolled CRS presented with increased percentage of anosmia and increased olfactory cleft CT, OCES, QOD-NS, and SNOT-22 scores than patients with controlled CRS. Researchers note that the CT and OCES results indicate that both the active inflammation and the diseased mucosa within the olfactory cleft contribute to the olfactory deterioration among patients with uncontrolled CRS. Study limitations included small sample size and its cross-sectional nature.
CITATION: Hong J, Wang Z, and Wu D, et al. Patterns of olfactory impairment among patients with uncontrolled chronic rhinosinusitis. Laryngoscope. 2024;134:2341–2348.