Postoperative evaluation of olfactory dysfunction in eosinophilic chronic rhinosinusitis – comparison of histopathological and clinical findings

Abstract

Background: Olfactory dysfunction in eosinophilic chronic rhinosinusitis (ECRS) is poorly understood.

Objective: To compare olfactory mucosal injury due to eosinophil infiltration in ECRS with postoperative olfactory function.

Methods: Seventeen ECRS patients (ECRS group) and 18 bilateral rhinosinusitis (non-ECRS group) patients were compared. At 3 and 12 months post-endoscopic sinus surgery (ESS), all patients were evaluated for subjective symptoms (nasal obstruction, nasal discharge and olfactory dysfunction), endoscopic nasal findings, CT score and T&T olfactometer recognition threshold test. The eosinophil count, OMP-positive cells and epithelial erosion in olfactory mucosa collected during ESS were compared with the postoperative olfactory function.

Results: The non-ECRS group showed significant improvement in all clinical findings at 3 and 12 months, but the ECRS group showed worsening of the olfactory dysfunction symptoms and T&T olfactometer recognition threshold at 12 months because of recurrence of sinusitis. The groups differed significantly in the ΔT&T value (i.e. pre-ESS T&T recognition threshold – post-ESS T&T recognition threshold) at both 3 and 12 months, and the degree of olfactory improvement differed. Histologically, the ECRS group showed significantly more eosinophils, fewer OMP-positive cells and greater epithelial erosion than the non-ECRS group.

Conclusions: Eosinophilic inflammation was thought to cause olfactory mucosal injury/dysfunction.

背景：嗜酸粒细胞性慢性鼻窦炎（ECRS）患者的嗅觉功能障碍尚不清楚。

目的：比较ECRS患者的嗜酸性粒细胞浸润致嗅粘膜损伤与术后嗅觉功能的关系。

方法：对17例（ECRS组）和18例（非ECRS组）双侧鼻窦炎患者进行比较。在鼻内镜鼻窦手术（ESS）后的3个月和12个月, 对所有患者的主观症状（鼻阻塞、鼻分泌物和嗅觉障碍）、鼻内镜检查结果、CT评分和T&T嗅觉仪识别阈值测试进行评估。比较ESS术中收集的嗅粘膜嗜酸性粒细胞计数、OMP阳性细胞和上皮糜烂与术后嗅觉功能的关系。

结果：非ECRS组在3个月和12个月时的所有临床表现均有明显改善, 但由于鼻窦炎复发, ECRS组在12个月时的嗅觉功能障碍症状和T&T嗅觉仪识别阈值均变得更糟。两组在3个月和12个月时的ΔT&T值（即ESS前T&T识别阈值-ESS后T&T识别阈值）有显著差异, 嗅觉改善程度也有差异。组织学上, ECRS组比非ECRS组表现出更多的嗜酸性粒细胞、更少的OMP阳性细胞和程度更大的上皮侵蚀。

结论：嗜酸性炎症被认为会导致嗅觉粘膜损伤或功能障碍

Keywords:

• Sensorineural olfactory dysfunction
• conductive olfactory dysfunction
• eosinophilic chronic rhinosinusitis
• olfactory mucosa injury
• postoperative olfactory function
• endoscopic sinus surgery

Disclosure statement

There were no conflicts of interest in this study.