Olfactory function in patients with chronic rhinosinusitis before and after functional endoscopic sinus surgery.
BACKGROUND
The olfactory loss in patients with chronic rhinosinusitis has been measured by different methods. However, the results have been variable and it is not clear whether functional endoscopic sinus surgery (FESS) significantly improves olfactory function. This study was performed to evaluate the influences of FESS on olfactory function in patients with chronic rhinosinusitis using three different types of olfactory tests.


METHODS
Seventy patients with chronic rhinosinusitis were administered the University of Pennsylvania Smell Identification Test (UPSIT), a single staircase phenyl ethyl alcohol odor detection threshold test (STT), and a short-term odor memory/discrimination test a day before and 6 months after FESS. A questionnaire inquiring about the patients' self-perception of olfactory function was administered also. Independent ratings of the severity of chronic rhinosinusitis before FESS were established from CT scans.


RESULTS
Fifty-two (74.3%) of the patients reported that their olfactory function was impaired before surgery, and 68.6% of the patients reported impaired olfactory function after surgery, a difference that was not significant. No meaningful changes in any of the olfactory test scores were noted 6 or more months after FESS. Preoperatively, small correlations between CT scores and the symptom scores (r = 0.278; p = 0.024), threshold scores (r = -0.27; p = 0.031), and UPSIT scores (r = -0.36; p = 0.003) were observed.


CONCLUSIONS
In patients with severe rhinosinusitis, FESS had little impact on the ability to smell, regardless of the method for assessing smell function. Subtle associations between olfactory function and the severity of chronic rhinosinusitis determined by CT were observed, however, preoperatively. The olfactory test measures were correlated with one another both pre- and postoperatively.
Jiang
Rong-San
RS
Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan. rsjiang@vghtc.gov.tw
Lu
Fung-Jou
FJ
Liang
Kai-Li
KL
Shiao
Jiun-Yi
JY
Su
Mao-Chang
MC
Hsin
Chung-Han
CH
Chen
Wen-Kang
WK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D012220:Rhinitis / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D012720:Severity of Illness Index; D012852:Sinusitis / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D012903:Smell / Q000502:physiology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome