Does olfactory function improve after endoscopic sinus surgery?
OBJECTIVE
To examine the impact of endoscopic sinus surgery (ESS) on olfactory impairment in patients with chronic rhinosinusitis (CRS) over intermediate and long-term follow-up. We hypothesized that patients with mild olfactory dysfunction (hyposmia) would benefit from ESS, whereas patients with severe olfactory dysfunction (anosmia) would not.


METHODS
Prospective, multi-institutional cohort study.


METHODS
A total of 111 patients presenting for ESS for treatment of CRS were examined preoperatively, and at 6 and 12 months postoperatively. Demographic, comorbidity, and Smell Identification Test (SIT) data were collected at each time point. Univariate and multivariate analyses were performed.


RESULTS
The prevalence of gender-adjusted olfactory dysfunction prior to surgery was 67.5 percent. Surprisingly, hyposmic patients did not significantly improve after surgery. In contrast, patients with anosmia significantly improved after ESS (baseline, 6-month SIT scores: 9.7 +/- 2.0, 21.3 +/- 11.2; P = 0.001). Improvement was sustained at 12-month follow-up (21.7 +/- 10.7; P = 0.001). Multivariate linear regression analysis showed that baseline olfactory category and nasal polyposis were significantly associated with improvement in postoperative olfactory function (P = 0.035, P = 0.002).


CONCLUSIONS
Contrary to our hypotheses, patients with severe olfactory dysfunction significantly improved after ESS and sustained improvement over time, whereas patients with mild olfactory dysfunction did not.
Litvack
Jamie R
JR
Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR 97239, USA.
Mace
Jess
J
Smith
Timothy L
TL
D000328:Adult; D002908:Chronic Disease; D004724:Endoscopy; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D000857:Olfaction Disorders / Q000209:etiology / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures; D011446:Prospective Studies; D020127:Recovery of Function; D012220:Rhinitis / Q000503:physiopathology / Q000601:surgery*; D012852:Sinusitis / Q000503:physiopathology / Q000601:surgery*; D012903:Smell / Q000502:physiology*