title: Predictors of olfactory dysfunction in rhinosinusitis using the brief smell identification test.
abstract: OBJECTIVE
  Associations between olfactory function to quality-of-life (QOL) and disease severity in patients with rhinosinusitis is poorly understood. We sought to evaluate and compare olfactory function between subgroups of patients with rhinosinusitis using the Brief Smell Identification Test (B-SIT).
  
  
  METHODS
  Cross-sectional evaluation of a multicenter cohort.
  
  
  METHODS
  Patients with recurrent acute sinusitis and chronic rhinosinusitis with and without nasal polyposis were prospectively enrolled from three academic tertiary care sites. Each subject completed the B-SIT, in addition to measures of disease-specific QOL. Patient demographics, comorbidities, and clinical measures of disease severity were compared between patients with normal (BSIT≥9) and abnormal (BSIT<9) olfaction scores. Regression modeling was used to identify potential risk factors associated with olfactory impairment.
  
  
  RESULTS
  Patients with rhinosinusitis (n=445) were found to suffer olfactory dysfunction as measured by the B-SIT (28.3%). Subgroups of rhinosinusitis differed in the degree of olfactory dysfunction reported. Worse disease severity, measured by computed tomography and nasal endoscopy, correlated to worse olfaction. Olfactory scores did not consistently correlate with the Rhinosinusitis Disability Index or Sinonasal Outcome Test scores. Regression models demonstrated nasal polyposis was the strongest predictor of olfactory dysfunction. Recalcitrant disease and aspirin intolerance were strongly predictive of worse olfactory function.
  
  
  CONCLUSIONS
  Olfactory dysfunction is a complex, multifactorial process found to be differentially expressed within subgroups of rhinosinusitis. Olfaction was associated with disease severity as measured by imaging and endoscopy, with only weak associations to disease-specific QOL measures.
  
  
  METHODS
  2b.
authors.affiliation: Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon.
authors.forename: Jeremiah A
authors.initials: JA
authors.lastname: Alt
authors.forename: Jess C
authors.initials: JC
authors.lastname: Mace
authors.forename: Maria C F
authors.initials: MC
authors.lastname: Buniel
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Soler
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
mesh_terms: D002908:Chronic Disease; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D000857:Olfaction Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012220:Rhinitis / Q000150:complications* / Q000503:physiopathology; D012720:Severity of Illness Index; D012852:Sinusitis / Q000150:complications* / Q000503:physiopathology; D012903:Smell / Q000502:physiology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Olfaction disorders; inflammation; quality of life; sinusitis; smell