Orthonasal and retronasal olfactory function in patients with chronic rhinosinusitis without nasal polyps undergoing endoscopic sinonasal surgery.

IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY International Forum of Allergy & Rhinology Pub Date : 2024-10-10 DOI:10.1002/alr.23467
Paolo Boscolo-Rizzo, Claire Hopkins, Thomas Hummel, Anna Menini, Francesco Uderzo, Giulia Provenza, Giacomo Spinato, Enzo Emanuelli, Giancarlo Tirelli
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Abstract

Background: Olfactory dysfunction (OD) is a key symptom of chronic rhinosinusitis (CRS). Although extensively studied in CRS with nasal polyps (CRSwNP), OD in CRS without nasal polyps (CRSsNP) remains under-researched. This study aims to assess the prevalence of OD and its evolution in surgically naïve patients with CRSsNP undergoing endoscopic sinus surgery (ESS).

Methods: This prospective study included 97 participants with CRSsNP (mean age, 46.5 years; 70.1% men) and 97 healthy controls (mean age, 46.5 years; 70.1% men). Participants underwent psychophysical evaluations of orthonasal (using the Sniffin' Sticks test) and retronasal olfaction (using powdered aromas) at enrolment and 6 months post-ESS.

Results: Out of 97 patients, 81 (83.5%) completed all assessments. At enrolment, 23 (28.4%) CRSsNP patients had OD based on composite threshold, discrimination, identification scores, compared with 7 (8.6%) controls (absolute % difference, 19.8% [95% CI, 8.2-31.4]). Retronasal olfactory function was also significantly worse in CRSsNP patients. Six months post-ESS, 30 patients (37.0%) experienced a clinically significant improvement in olfactory, whereas nonsignificant changes were observed in retronasal olfactory score, and 3.7% of patients experienced a deterioration of the olfactory function.

Conclusions: In conclusion, although 37% of patients experienced a clinically significant improvement in their sense of smell following ESS, the overall prevalence of OD in this surgically naive population appears relatively low, especially when compared to that observed in patients with CRSwNP. Therefore, ESS may offer some benefits for enhancing orthonasal olfactory function, but the extent of these improvements appears to be limited.

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接受鼻窦内窥镜手术的无鼻息肉慢性鼻窦炎患者的正鼻腔和反鼻腔嗅觉功能。
背景:嗅觉功能障碍(OD)是慢性鼻炎(CRS)的一个主要症状。虽然对有鼻息肉的慢性鼻炎(CRSwNP)进行了广泛研究,但对无鼻息肉的慢性鼻炎(CRSsNP)的嗅觉障碍研究仍然不足。本研究旨在评估接受内窥镜鼻窦手术(ESS)的无鼻息肉 CRS 患者的 OD 患病率及其演变情况:这项前瞻性研究包括 97 名 CRSsNP 患者(平均年龄 46.5 岁;70.1% 为男性)和 97 名健康对照者(平均年龄 46.5 岁;70.1% 为男性)。参与者在入学时和接受心理治疗后 6 个月接受了正鼻嗅觉(使用嗅棒测试)和反鼻嗅觉(使用香粉)的心理物理评估:97 名患者中,81 人(83.5%)完成了所有评估。入学时,根据阈值、辨别力和识别力的综合评分,23 名(28.4%)CRSsNP 患者有 OD,而对照组为 7 名(8.6%)(绝对百分比差异为 19.8% [95% CI, 8.2-31.4])。CRSsNP 患者的视网膜嗅觉功能也明显较差。ESS后6个月,30名患者(37.0%)的嗅觉有了临床意义上的显著改善,而视网膜嗅觉评分则无明显变化,3.7%的患者嗅觉功能恶化:总之,尽管 37% 的患者在接受 ESS 治疗后嗅觉有了明显改善,但在这一未接受手术的人群中,OD 的总体发病率似乎相对较低,尤其是与在 CRSwNP 患者中观察到的情况相比。因此,ESS 可为增强正鼻嗅觉功能带来一些益处,但其改善程度似乎有限。
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来源期刊
CiteScore
11.70
自引率
10.90%
发文量
185
审稿时长
6-12 weeks
期刊介绍: International Forum of Allergy & Rhinologyis a peer-reviewed scientific journal, and the Official Journal of the American Rhinologic Society and the American Academy of Otolaryngic Allergy. International Forum of Allergy Rhinology provides a forum for clinical researchers, basic scientists, clinicians, and others to publish original research and explore controversies in the medical and surgical treatment of patients with otolaryngic allergy, rhinologic, and skull base conditions. The application of current research to the management of otolaryngic allergy, rhinologic, and skull base diseases and the need for further investigation will be highlighted.
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