title: Improvement of olfactory function for quality of life recovery.
abstract: OBJECTIVE
  To explore quality of life (QoL) improvement after treatment of patients with chronic olfactory disorders; and to correlate QoL with olfactory rehabilitation and evaluate olfactory improvement values over which QoL outcomes are significantly recovered.
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  Eighty-nine patients following endoscopic sinus surgery for chronic rhinosinusitis (CRS) and immunotherapy for allergic rhinitis (AR) were studied. Olfactory function was evaluated using Sniffin' Sticks test pre-and 12 months after treatment. All patients completed six validated QoL questionnaires either specific for olfaction (Questionnaire of Olfactory Deficits-QOD) and for assessing mental health (Zung Anxiety Scale, State-Trait Anxiety Inventory, Zung Depression Scale, Beck Depression Inventory), or generic one (Short Form-36).
  
  
  RESULTS
  Significant improvement (all P < 0.001) of olfactory function by 27.4% in total cohort (AR: 10.4%, P = 0.004; CRS: 39.9%, P < 0.001), expressed by the combined Threshold-Discrimination-Identification (TDI) score-and of all QoL questionnaires scores (all P < 0.01) as well, was observed after treatment. There was a positive correlation between olfactory recovery and improvement of patients' QoL. ROC analysis revealed that an increase in the TDI score by 3.50 points in AR and 4.75 points in CRS was necessary for a clinically significant improvement in all QoL questionnaires results.
  
  
  CONCLUSIONS
  QoL and mental health of patients suffering from chronic sinonasal diseases are totally recovered after treatment, presenting a direct positive relationship with smell improvement. An increase of olfactory function by 3.50 points for AR and 4.75 points for CRS might be considered the cutoff point for patients' QoL significant recovery.
authors.affiliation: Department of Otorhinolaryngology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
authors.forename: Michael
authors.initials: M
authors.lastname: Katotomichelakis
authors.forename: Efthimios
authors.initials: E
authors.lastname: Simopoulos
authors.forename: Gregory
authors.initials: G
authors.lastname: Tripsianis
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Prokopakis
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Danielides
authors.forename: Stelios George
authors.initials: SG
authors.lastname: Velegrakis
authors.forename: Miltos
authors.initials: M
authors.lastname: Livaditis
authors.forename: Vassilios
authors.initials: V
authors.lastname: Danielides
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D000857:Olfaction Disorders / Q000503:physiopathology* / Q000534:rehabilitation*; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012903:Smell / Q000502:physiology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Olfactory function; allergic rhinitis; chronic rhinosinusitis; endoscopic sinus surgery; quality of life; sniffin' sticks