Outcomes in endoscopic sinus surgery: olfaction, nose scale and quality of life in a prospective cohort study.
OBJECTIVE
To determine the efficacy of endoscopic sinus surgery (ESS) on olfactory function in chronic rhinosinusitis patients with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP) and to compare the nasal obstruction and symptom evaluation (NOSE) scale before and after surgery.


METHODS
A prospective cohort study SETTING: Royal National Throat and Nose and Ear Hospital, London UK.


METHODS
One hundred and thirteen patients with CRS; 60 CRSwNP and 53 CRSsNP.


METHODS
Olfaction was measured using both the University of Pennsylvania Smell Investigation Test (UPSIT) and the 'sense of smell' visual analogue scale (VAS). The NOSE scale, the sinonasal outcome test (SNOT 22) and the Lund-Kennedy (LK) surgeon reported scores were also measured pre- and postoperatively at 6 months.


RESULTS
The UPSIT psychophysical measurement significantly improved following ESS in the CRSwNP subgroup as did the patients perceived VAS sense of smell. However, in the CRSsNP subgroup, the improved VAS and UPSIT measurements were not significant. The NOSE, SNOT 22 and LK scores all improved significantly. The olfactory improvement as measured by the UPSIT correlated to the SNOT-22, but a correlation between the NOSE score and UPSIT was not found.


CONCLUSIONS
Endoscopic sinus surgery significantly improved the patient's perceived and measured sense of smell in the CRSwNP subgroup which is the most surgically responsive CRS subgroup. Additionally, improved olfaction in the CRSwNP subgroup is most likely to improve the patient's quality of life. Endoscopic sinus surgery significantly improved the NOSE scale in both CRS subgroups at 6 months following surgery.
Department of Rhinology and Facial Plastic Reconstructive Surgery, The Royal National Throat, Nose & Ear Hospital, London, UK.|The EAR Institute, University College London, London, UK.
P J
PJ
Andrews
ENT Department, University Hospital of Liege, Liege, Belgium.
A-L
AL
Poirrier
Department of Rhinology and Facial Plastic Reconstructive Surgery, The Royal National Throat, Nose & Ear Hospital, London, UK.|The EAR Institute, University College London, London, UK.
V J
VJ
Lund
Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, UK.
D
D
Choi
D000328:Adult; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D009298:Nasal Polyps / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D012220:Rhinitis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D012852:Sinusitis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D012903:Smell / Q000502:physiology; D016896:Treatment Outcome