title: Olfactory Outcomes after Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Meta-analysis.
abstract: To use combined pre- and postsurgical olfactory outcomes to assess the impact of endoscopic sinus surgery on chronic rhinosinusitis-related olfactory impairment.
  
  
  
  CINAHL, Cochrane, OVID, EMBASE, PubMed, and SCOPUS. Each database was searched from inception up to October 2015.
  
  
  
  Studies were included that reported subjective or objective olfactory data in chronic rhinosinusitis patients before and after endoscopic sinus surgery.
  
  
  
  Thirty-one studies were used in the meta-analysis. Weighted mean differences of olfactory measures demonstrated significant improvement in mixed CRS patients (those with and without polyps) through visual analog scales (-0.83, P = .001), altered taste/smell item on Sinonasal Outcome Test (-1.32, P < .00001), 40-item Smell Identification Test (3.49, P = .0010), and Sniffin' Sticks identification (0.34, P = .03). Chronic rhinosinusitis mixed patients demonstrated nonsignificant improvements via Sniffin' Sticks threshold (1.60, P = .16) and Brief Smell Identification Test (0.20, P = .32). When separated, polyp patients and dysosmic patients experienced the highest levels of olfactory improvement. Polyp patients improved by 7.87 (P = .006) on the 40-item Smell Identification test, 11.54 (P < .0001) with the Sniffin' Sticks total score, and 2.57 (P < .00001) through Sniffin' Sticks identification. Dysosmic patients improved by 5.75 via the 40-item Smell Identification Test (P = .0001).
  
  
  
  Endoscopic sinus surgery improves nearly all subjective and objective measures of olfaction in chronic rhinosinusitis patients. Patients with nasal polyposis or preoperative olfactory dysfunction improve to a greater degree.
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA pkohli89@gmail.com.
authors: Preeti
authors: P
authors: Kohli
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors: Akash N
authors: AN
authors: Naik
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors: Zachary
authors: Z
authors: Farhood
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors: Adrian A
authors: AA
authors: Ong
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors: Shaun A
authors: SA
authors: Nguyen
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
authors: Zachary M
authors: ZM
authors: Soler
authors: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.|Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA.
authors: Rodney J
authors: RJ
authors: Schlosser
mesh_terms: D002908:Chronic Disease; D006801:Humans; D007828:Laryngoscopy / Q000379:methods; D009298:Nasal Polyps / Q000150:complications / Q000601:surgery; D000857:Olfaction Disorders / Q000534:rehabilitation; D010256:Paranasal Sinuses / Q000601:surgery; D011788:Quality of Life; D065631:Rhinitis, Allergic / Q000601:surgery*; D018570:Risk Assessment; D012307:Risk Factors; D012852:Sinusitis / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: chronic rhinosinusitis; meta-analysis; olfaction; sinus surgery; sinusitis; smell