title: Objective olfactory outcomes after revision endoscopic sinus surgery.
abstract: BACKGROUND
  Patients who suffer from hyposmia and anosmia report a negative effect on their overall quality of life. Smell disturbance of patients with chronic rhinosinusitis (CRS) can improve after endoscopic sinus surgery (ESS). Although several studies have shown that 50-83% of patients may notice an improvement in olfactory function after ESS, the olfactory improvement after revision ESS (RESS), especially by objective measurements, is still lacking.
  
  
  METHODS
  Olfactory function was assessed by the traditional Chinese version of the University of Pennsylvania Smell Identification Test (UPSIT-TC) preoperatively and postoperatively, recorded as smell identification test (SIT) score. Olfactory outcomes from anosmia to hyposmia/normosmia, or from hyposmia to normosmia, were considered as "improvement." Postoperative assessments were divided into two periods: period 1 (P1) is defined as >6 but <12 months postoperatively; period 2 (P2) is defined as >12 but <24 months postoperatively.
  
  
  RESULTS
  Thirty-two patients with smell disturbance preoperatively (period 0 [P0]) and confirmed by UPSIT-TC were enrolled into this study. Mean SIT score at P0 was 13.3; mean SIT score at P1 was 18.6; mean SIT score at P2 was 20.4. The presence of nasal polyps blocking the olfactory cleft were associated with better olfaction improvements (p < 0.05) as was the degree of mucosal swelling. The overall improvement rates were 44.8 and 47.8% at P1 and P2, respectively.
  
  
  CONCLUSIONS
  RESS resulted in objective evidence of olfactory improvement in approximately one-half of our cohort over 16 months of follow-up and offers a treatment option for an otherwise poor prognosis condition.
authors.affiliation: Department of Otolaryngology, Kuang-Tien General Hospital, Taichung, Taiwan.
authors.forename: Chao-Yuan
authors.initials: CY
authors.lastname: Hsu
authors.forename: Ying-Piao
authors.initials: YP
authors.lastname: Wang
authors.forename: Ping-Hung
authors.initials: PH
authors.lastname: Shen
authors.forename: Erik Kent
authors.initials: EK
authors.lastname: Weitzel
authors.forename: Jen-Tsung
authors.initials: JT
authors.lastname: Lai
authors.forename: Peter-John
authors.initials: PJ
authors.lastname: Wormald
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications / Q000601:surgery*; D059747:Nasal Surgical Procedures / Q000379:methods; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D000857:Olfaction Disorders / Q000209:etiology / Q000601:surgery*; D011379:Prognosis; D012220:Rhinitis / Q000150:complications / Q000601:surgery*; D012852:Sinusitis / Q000150:complications / Q000601:surgery*; D012903:Smell; D016896:Treatment Outcome