Self-reported course of olfactory impairment determines outcome for successful surgical intervention in nasal polyps with anosmia

Abstract

Background

Olfactory impairment is one of important symptoms of Chronic rhinosinusitis with nasal polyps (CRSwNP). However, the relationship between course of olfactory impairment and postoperative symptom improvement was still unclear.

Objective

The aim of this study was to assess the relationship between the self-reported course of olfactory loss and the degree of improvement in olfaction to determine the timing for successful surgical intervention in improving olfaction in patients with CRSwNP.

Materials and Methods

A total of 86 CRSwNP patients with loss of smell and undergoing functional endoscopic sinus surgery (FESS) were recruited consecutively. The self-reported course of smell lose before treatment was recorded. Olfactory function was recorded before and after FESS using T&T Olfactometry.

Results

Fifty-seven patients demonstrated recovery of olfaction and 29 patients no-recovery. The average recovery time of smell loss in the study was 2.6 weeks. The course of smell loss showed moderate accuracy as a marker for determining the timing for successful FESS; with up to 4.5 years of self-reported smell loss being the cut-off point for recovery of smell following FESS.

Conclusion

This study suggests that FESS in CRSwNP patients with self-reported significant olfactory impairment for less than 4.5 years may lead to improvement in olfaction.

Significance

FESS in CRSwNP patients with self-reported significant olfactory impairment persisting for less than 4.5 years may lead to considerable improvement in olfaction in these patients.

Chinese abstract

背景：嗅觉障碍是鼻息肉慢性鼻窦炎（CRSwNP）的重要症状之一。但是, 嗅觉障碍的病程与术后症状改善之间的关系仍不清楚。

目的：本研究的目的是评估自我报告的嗅觉丧失过程和嗅觉改善程度之间的关系, 以确定为改善CRSwNP患者嗅觉而进行手术有效干预的时机。

材料与方法：本研究包括86例出现嗅觉丧失的CRSwNP患者。他们接受了功能内镜鼻窦手术（FESS）。自我报告的治疗前气味消失过程得以记录。使用T&T嗅觉测定法记录FESS前后的嗅觉功能。

结果：57例患者嗅觉恢复, 29例患者无恢复。该研究的气味消失的平均恢复时间为2.6周。味觉损失的过程作为确定成功FESS时机的标志显示出中等的准确性。长达4.5年的自我报告味觉损失是FESS后气味恢复的临界点。

结论：本项研究表明, 对于自我报告显示嗅觉病程少于4.5年的CRSwNP患者, FESS可能会导致嗅觉改善。

意义：自我报告有严重嗅觉障碍持续存在少于4.5年的CRSwNP患者的FESS可能会导致这些患者的嗅觉显著改善。

Keywords:

• Chronic rhinosinusitis
• course of smell loss
• functional endoscopic sinus surgery
• predictive
• receiver operative curve
• T&T olfactometry

Disclosure statement

The authors declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of the manuscript entitled.

Additional information

Funding

This work was supported by National Natural Science Foundation of China [81900916]; Beijing Municipal Administration of Hospitals' Youth Programme [QML20190208]; The Priming Scientific Research Foundation for the Junior Researcher in Beijing Tongren Hospital, Capital Medical University [2018-YJJ-ZZL039]; Program for Changjiang Scholars and Innovative Research Team [IRT13082]; National Science Fund for the Major International Joint Research Program [81420108009]; CAMS Innovation Fund for Medical Sciences (2019-I2M-5-022).