Olfactory dysfunction in sinusitis with infiltration of numerous activated eosinophils.
OBJECTIVE
To compare the number of activated eosinophils in the ethmoidal sinus mucosa with the computed tomographic findings and degree of olfactory dysfunction, and study the clinical characteristics of this disease.


METHODS
Ethmoidal sinus mucosal specimens were obtained from 84 patients with bilateral sinusitis accompanied by endoscopic sinus surgery (ESS). The percentage of activated eosinophils identified by staining with EG2 antibody was compared with the nasal symptoms (nasal obstruction, nasal discharge, headache, problems of smell and overall), the CT images and the olfactory dysfunction assessed using the T&T olfactometry kit and the Alinamin test. In addition, comparison was made of the endoscopic findings obtained after the ESS and the results of the T&T olfactometry assessment.


RESULTS
Specimens from 42 patients were classified in the group showing a high percentage of EG2-positive cells, while specimens from 40 patients were classified in the group showing a low percentage of EG2-positive cells. Comparison of the subjective symptoms in these two groups found a statistically significant difference only in relation to "problems of smell", while comparison of the two groups in terms of the CT scan findings found significant differences only in relation to the anterior and posterior ethmoidal sinuses. In addition, it was found that there was a possibility of manifestation of olfactory dysfunction in the group with a high percentage of EG2-positive cells even when the overall CT score was low. Comparison of the postoperative ethmoidal sinus endoscopic findings and the results using the T&T Olfactometry kit revealed that olfactory dysfunction occurs together with aggravation of the lesions.


CONCLUSIONS
For the diagnosis of sinusitis accompanied by severe infiltration of activated eosinophils, attention should be paid not only to the eosinophil counts in the blood and the tissues, but also to the clinical findings, such as the status of lesions in the ethmoidal sinus as seen in CT scans and the manifestation of olfactory dysfunction.
Haruna
Shinichi
S
Department of Otolaryngology, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo 105, Japan. haruna@jikei.ac.jp
Otori
Nobuyoshi
N
Moriyama
Hiroshi
H
Nakanishi
Marcio
M
D000328:Adult; D000911:Antibodies, Monoclonal; D004724:Endoscopy; D047091:Eosinophil Granule Proteins; D004804:Eosinophils / Q000378:metabolism*; D015521:Ethmoid Sinusitis / Q000150:complications / Q000000981:diagnostic imaging / Q000276:immunology*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000378:metabolism*; D000857:Olfaction Disorders / Q000209:etiology / Q000276:immunology*; D014057:Tomography, X-Ray Computed
D000911:Antibodies, Monoclonal; D047091:Eosinophil Granule Proteins