title: Olfactory-specific quality of life outcomes after endoscopic sinus surgery.
abstract: BACKGROUND
  Olfactory loss is a cardinal symptom of chronic rhinosinusitis (CRS) and affects 40% to 80% of patients. However, common sinus-specific quality-of-life (QOL) instruments include only single questions related to olfaction. Few studies have explored olfactory outcomes after surgery utilizing validated, olfaction-specific QOL questionnaires.
  
  
  METHODS
  Patients with CRS were enrolled from 3 centers across North America into a prospective cohort study. Patients completed the short modified version of the Questionnaire of Olfactory Disorders (QOD-NS) and the 40-item Smell Identification Test (SIT-40) before and at least 6 months after endoscopic sinus surgery (ESS). Multivariate linear regression was used to determine whether specific demographic, comorbidity, or disease severity measures were independently associated with QOD scores at baseline or predicted change after surgery.
  
  
  RESULTS
  A total of 121 patients, equally split between genders, were enrolled with an average age of 47.9 years (range, 18-80 years). Baseline total QOD-NS scores were significantly associated with SIT-40 scores, with a moderate strength of correlation (Rs = 0.400; p < 0.001). The average QOD-NS score improved after ESS (35.7 ± 13.0 vs 39.7 ± 12.2; p = 0.006). Allergy, polyps, and steroid-dependent conditions were found to be independently associated with worse preoperative QOD-NS scores, whereas septal deviation was associated with better QOD-NS scores. Baseline computed tomography (CT) scores were the only variable that significantly predicted change in QOD-NS after surgery.
  
  
  CONCLUSIONS
  Olfaction-specific QOL is worse in patients with polyps and comorbid allergy. Significant improvements in olfaction-specific QOL are seen after ESS, with the greatest gains seen in those with worse CT scores at baseline.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC.
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Soler
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland, OR.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT.
authors.forename: Jeremiah A
authors.initials: JA
authors.lastname: Alt
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Denver, CO.
authors.forename: Vijay R
authors.initials: VR
authors.lastname: Ramakrishnan
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland, OR.
authors.forename: Jess C
authors.initials: JC
authors.lastname: Mace
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC.
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Schlosser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015897:Comorbidity; D004724:Endoscopy; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000601:surgery; D000857:Olfaction Disorders / Q000601:surgery*; D010256:Paranasal Sinuses / Q000601:surgery; D011446:Prospective Studies; D011788:Quality of Life; D012220:Rhinitis / Q000601:surgery*; D012852:Sinusitis / Q000601:surgery*; D055815:Young Adult
keywords: clinical outcomes; olfaction; patient-reported outcome measures; quality of life; sinusitis