Correlation between olfactory severity ratings based on olfactory function test scores and self-reported severity rating of olfactory loss

Conclusion: Olfactory test scores are significantly correlated with self-rated severity scales. However, the statistical rating based on olfactory tests did not strongly agree with the self-reported severity rating. This suggests that there is a discrepancy between olfactory test results and the severity described by patients themselves.

Objectives: This study aimed to identify the correlation between statistical ratings based on test scores and self-rating of the severity of olfactory loss.

Method: A total of 1555 subjects were asked to rate olfactory loss severity by one of five scales. Olfactory tests consist of the butanol threshold test (BTT) and cross-cultural smell identification test (CCSIT).

Results: There were significant correlations between BTT scores and self-rated severity scales (r?=?0.619, p?r?=?0.597, p?p?p?相似文献   

伴有嗅觉障碍的慢性鼻-鼻窦炎患者鼻内镜术后嗅觉及生活质量转归的研究

目的 探讨伴有嗅觉障碍的慢性鼻-鼻窦炎(CRS)(伴有/不伴有鼻息肉)患者经鼻内镜手术后嗅觉的转归及其生活质量(QOL)的改善情况。 方法 伴有嗅觉障碍的慢性鼻-鼻窦炎患者44例,其中伴有鼻息肉的患者33例,不伴有鼻息肉的患者11例,于术前行鼻部CT检查(冠状位+矢状位),Lund-Mackay CT评分,并分别于术前、术后4周及12周行T& T嗅觉测试、嗅觉VSA评分及鼻腔鼻窦结局测试(SNOT-20)。 结果 术后4周嗅觉T& T测试59.5%的患者嗅觉有改善,术后12周73.0%的患者嗅觉有改善。术后4周嗅觉vas评分有77.3%的患者嗅觉有改善,术后12周86.4%的患者嗅觉有改善。统计学显示嗅觉T& T测试及嗅觉VAS评分术后4周及12周的得分较术前明显改善(P<0.000 1),术后4周及12周差异无统计学意义(P=0.720,0.147)。SNOT-20评分术前与术后4周及12周均有统计学差异(P<0.000 1),术后4周与12周差异无统计学意义(P=0.055)。术前Lund-Mackay CT评分与T& T嗅觉测试、嗅觉VAS评分呈正相关(r=0.569,P<0.000 1;r=0.782,P<0.000 1)。 结论 鼻内镜术后患者嗅觉及QOL均明显改善,术后4周与12周改善程度差异无统计学意义。患者术前病变范围与嗅觉障碍程度呈正比。     

TRPC6与OMP在慢性鼻-鼻窦炎患者嗅上皮中的表达及与嗅觉功能相关性分析

目的 研究瞬时受体电位通道6(TRPC6)与嗅觉标记蛋白(OMP)在慢性鼻-鼻窦炎(CRS)引起的嗅觉减退患者嗅上皮中的表达以及与嗅觉减退的关系.方法 收集20例CRS伴嗅觉减退的患者为实验组,10例鼻中隔偏曲且嗅觉正常患者为对照组.T&T嗅觉计测试检测两组患者的嗅觉,取手术中切除的嗅区黏膜作为研究对象.免疫组化和蛋白...     

改良鼻窦CT嗅区评分对慢性鼻-鼻窦炎鼻息肉嗅觉评估及预后判断的价值

目的　探讨改良鼻窦CT嗅区评分对慢性鼻-鼻窦炎鼻息肉患者术前嗅觉功能评估及术后嗅觉功能判断的价值。方法　前瞻性分析慢性鼻-鼻窦炎鼻息肉患者54例,排除合并哮喘、变应性鼻炎和伴有可能影响嗅觉功能的系统性因素。所有患者均接受功能性鼻内镜手术和规范的药物治疗,并行术后随访。根据鼻窦CT冠状位嗅裂区堵塞程度评为0、1、2分,分别对嗅裂前区（anterior olfactory cleft score,AOCS）（中鼻甲对应嗅裂区）和嗅裂后区（posterior olfactory cleft score,POCS）（上鼻甲对应嗅裂区）进行评分。术前所有患者均进行T&T嗅觉检测、嗅觉VAS评分和改良鼻窦CT嗅区评分和鼻窦CT Lund-Mackay评分,术后行T&T嗅觉检测、嗅觉VAS评分。分别将患者术前及术后6个月嗅觉阈值、嗅觉VAS评分与改良鼻窦CT嗅区评分和Lund-Mackay评分进行线性回归分析。结果　本研究纳入慢性鼻-鼻窦炎鼻息肉患者54例,其中男性36例,女性18例,平均年龄47.9岁（24～67岁）,其中30例患者随访达到6个月。线性回归分析结果显示,患者T&T嗅觉阈值与嗅觉VAS评分有显著相关性（Pearson相关系数r =0.70,P <0.01）。手 术前改良鼻窦CT嗅区评分AOCS和POCS均与嗅觉阈值评分、嗅觉VAS评分显著正相关（P <0.001）,Lund-Mackay评分与嗅觉阈值也有弱相关性（R 2=0.262,P =0.005）。手术前鼻窦CT嗅区评分AOCS、POCS与术后6个月的嗅觉阈值亦有相关性（R 2=0.211、0.181,P =0.014、0.024）,且术前AOCS与术后6个月嗅觉阈值正相关性更强。术前Lund-Mackay评分与术后6个月嗅觉阈值无相关性（R 2=0.073,P =0.165）。结论　改良鼻窦CT嗅区评分可作为慢性鼻-鼻窦炎鼻息肉患者术前嗅觉功能和功能性鼻内镜手术后嗅觉功能预后的客观评价指标。中鼻甲对应的嗅裂区的病变程度对嗅觉功能评价作用更重要。     

Circadian anosmia: A rare clinical presentation

We report the case of a 27‐year‐old female who presented with a peculiar story of anosmia fluctuating in a circadian manner. Olfactory function appeared an hour after breakfast, was normal during daytime, and disappeared in the early evening. Imaging confirmed chronic rhinosinusitis (CRS). Initial systemic, followed by topical steroid treatment, rapidly and sustainably reversed this condition. The olfactory fluctuation paralleled the endogenous steroid production. This suggests that slight congestion changes in a chronically inflamed nasal mucosa may have been sufficient to induce this circadian anosmia. The importance of identifying fluctuation of olfactory function as a sign of CRS is emphasized and discussed. Laryngoscope, 128:1537–1539, 2018     

Predictors of Olfactory Dysfunction in Patients With Chronic Rhinosinusitis

Objectives: To measure the prevalence of and identify clinical characteristics associated with poor olfactory function in a large cohort of patients with chronic rhinosinusitis (CRS). Study Design: Multi‐institutional, cross sectional analysis. Methods: An objective measure of olfactory dysfunction, the Smell Identification Test, demographic data, clinical factors, and comorbidity data were collected from a cohort of 367 patients who presented with CRS at three tertiary care centers. Data were analyzed using univariate and multivariate analyses. Results: Sixty‐four percent of men and women aged 18 to 64 had olfactory dysfunction whereas 95% of patients older than or equal to 65 years had olfactory dysfunction (P < .001); no significant difference was noted by gender. By multivariate logistic regression analysis, patients with nasal polyposis [Odds ratio (OR) 2.4, 95% confidence interval (CI) 1.3–4.2, P = .003] and patients older than or equal to 65 years (OR 10.0, 95% CI 2.3–43.7, P = .002) were at increased risk of hyposmia. Patients with nasal polyposis (OR 13.2, 95% CI 5.7–30.7, P < .001), asthma (OR 4.2, 95% CI 1.8–9.8, P = .001), older than or equal to 65 years (OR 15.6, 95% CI 2.3–104.9, P = .005), and smokers (OR 7.6, 95% CI 1.8–31.6, P = .005) were at increased risk of anosmia. Conclusions: Poor olfactory function is common in patients with CRS. Age, nasal polyposis, smoking, and asthma were significantly associated with olfactory dysfunction in patients with CRS. Neither prior endoscopic sinus surgery nor a history of allergic rhinitis was associated with olfactory dysfunction. Septal deviation and inferior turbinate hypertrophy were associated with normal olfactory function.     

Postoperative Olfactory Results in Chronic Rhinosinusitis with Nasal Polyposis According to Wound Healing Status

Objectives

Postoperative wound healing status has not been considered in earlier studies on olfactory changes after surgery. This may be a factor accounting for the equivocal postoperative olfactory results. The aim of this study was to investigate postoperative olfactory results according to wound healing status.

Methods

Fifty patients who underwent endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps with smelling disturbance were examined preoperatively, and at 6 months after surgery. Patients were divided into two groups according to postoperative Lund-Kennedy score: favorable and unfavorable wound healing. Preoperative ostiomeatal unit computed tomography (CT), such as Lund-Mackay score and olfactory cleft opacification score, clinical characteristics and olfactory function tests such as the butanol threshold test and cross-cultural smell identification test, and questionnaire responses were compared between the two groups.

Results

There were no differences in preoperative clinical characteristics between the favorable and unfavorable wound healing groups. The favorable wound healing group displayed greater improvement of olfactory results after surgery than the unfavorable wound healing group. Postoperative olfactory improvement patterns showed a hierarchy from subjective to objective improvement and from threshold to identification improvement. Patients who had postoperative favorable wound healing but showed no success of olfaction were characterized by more severe preoperative subjective symptoms and higher olfactory cleft opacification, especially in the upper part of olfactory cleft on preoperative CT scan.

Conclusion

Wound healing status is an apparent risk factor for postoperative olfactory improvement. Moreover, preoperative opacification in the olfactory cleft may predict bad olfactory results after surgery, even in patients with favorable wound healing.     

Functional endoscopic sinus surgery in children: predictive factors of outcome

The main objective of this study is to assess the results of functional endoscopic sinus surgery in children and to determine which factors independently influence the postoperative results. It is a prospective study by Mansoura University Hospital. 87 patients with different applications of pediatric endoscopic sinus surgery (PESS) chronic rhinosinusitis (CRS) with nasal allergy (45 patients), CRS without nasal allergy (36 patients) and CRS with polypsis (6 patients) from 2005 to 2010 were included. All children underwent endoscopic sinus surgery. All patients were clinically, radiologically and endoscopically monitored. In this study, the overall success rate was 87.69%, the success rate for CRS with nasal allergy was 87.5%, the success rate for CRS without nasal allergy was 85.7% and the success rate for CRS with polyposis was 93%. Regarding the patients’ age, it could affect the surgical score value (X ² = 9.446 and P* = 0.009). There was significant relation between type of the preoperative disease extent, adenoidectomy, second look operation and postoperative improvement. There was no significant relation between type of the preoperative disease or previous surgery and postoperative improvement. In conclusion, postoperative improvement was significantly correlated with extent of preoperative disease, adenoidectomy and second look operation and not significantly correlated with type of the preoperative disease or previous surgery. The results of PESS are influenced by age group, a younger age group is associated with more adhesions and recurrences and an older age group is associated with blood loss and higher surgical score. All these variables are contributing in the outcome of PESS.     

Predictors of quality of life outcomes in chronic rhinosinusitis after sinus surgery

The predictive value of olfaction for quality of life (QoL) recovery after endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) is still underestimated. The aim of this study was to explore the proportion of patients suffering from CRS who experience clinically significant QoL improvement after ESS and identify pre-operative clinical phenotypes that best predict surgical outcomes for QoL, focusing mainly on the role of patients’ olfaction. One hundred eleven patients following ESS for CRS and 48 healthy subjects were studied. Olfactory function was expressed by the combined “Threshold Discrimination Identification” score using “Sniffin’ sticks” test pre-treatment and 12 months after treatment. All subjects completed validated, widely used QoL questionnaires, specific for olfaction (Questionnaire of Olfactory Deficits: QOD), for assessing psychology (Beck Depression Inventory: BDI) and for general health (Short Form-36: SF-36). Statistically significant improvement of olfactory function by 41.8 % and of all QoL questionnaires scores (all p < 0.001) was observed on the 12-month follow-up examination. Clinically significant improvement for QoL was measured in a proportion of 56.8 % of patients on QOD, 64.9 % on SF-36 and 49.5 % on BDI scales results. Although olfactory dysfunction, nasal polyps, female gender, high socio-economic status and non-smoking habits were significantly associated with better QoL results, multivariate logistic regression analysis revealed that only olfactory dysfunction and nasal polyps were independent predictors significantly associated with higher likelihood of clinically significant improvement in all QoL questionnaire results. Olfactory dysfunction and nasal polyps were independent pre-operative predictors for surgical outcomes with regard to QoL results.     

The olfactory function in patients with common variable immunodeficiency

AimsTo determine the incidence of olfactory dysfunction in common variable immunodeficiency patients. To evaluate the correlation between olfactory dysfunction and chronic rhinosinusitis in this class of patients.Materials and methodsFifty patients, with a diagnosis of common variable immunodeficiency and under immunoglobulin replacement therapy, were submitted to an otolaryngology physical examination and a CT scan of the craniofacial structures in order to show the presence of signs of chronic rhinosinusitis. An olfactory function evaluation was executed using the Sniffin’ Sticks Test, with assessment of olfactory threshold, discrimination, identification and overall composite scores (TDI: threshold-discrimination-identification score).ResultsAn olfactory dysfunction was found in 23 (46%) common variable immunodeficiency patients, with hyposmia and anosmia respectively present in 65% and 38% of them. The mean TDI score in the study group was 27.7. Common variable immunodeficiency patients with CRS presented a more suggestive increase of the olfactory threshold, discrimination and identification compared to those without chronic rhinosinusitis.ConclusionIn conclusion, patients with common variable immunodeficiency seem to suffer from olfactory disorders more than healthy people. One of the causal factors could be considered the presence of rhinosinusal pathologies.     

Comparative outcomes of endoscopic sinus surgery in patients with chronic sinusitis and nasal polyps

This study was carried out to compare the outcomes of endoscopic sinus surgery in patients with chronic sinusitis without nasal polyps (CRS) and those with nasal polyps (NP). We also sought to determine the correlation between preoperative computed tomography (CT) findings and postoperative endoscopy and symptom score improvement. Data were collected from two groups of patients diagnosed as CRS with and without nasal polyps that underwent functional endoscopic sinus surgery with a 1-year postoperative follow up. Preoperative symptoms, CT scores, and endoscopic scores were recorded. Postoperative symptom and endoscopic scores were recorded at 1, 6, and 12 months. Assessment of symptoms was performed subjectively using visual analogue scoring (VAS). CT scan findings were scored using the Lund–Mackay system. Endoscopic examination findings were scored according to the staging system proposed by Lanza and Kennedy. The correlations between the CT score, endoscopic scores and VAS scores were calculated. There was a statistically significant correlation between the preoperative CT, symptom, and endoscopic scores. Postoperative symptom and endoscopic scores also showed a significant correlation. Total CT scores of the CRS group were significantly lower than the scores of the NP group. Also preoperative endoscopy and symptom scores were statistically lower in CRS group compared to NP group. Endoscopy total scores and symptom total scores of both groups were significantly decreased at postoperative 12th month. Statistically significant difference was observed between the preoperative and postoperative symptom and endoscopy scores. The patients with polyps had higher symptom scores and worse objective findings compared to the patients with CRS. In all patients groups, objective and subjective scores seemed to correlate well preoperatively and postoperatively. These data suggest that endoscopic sinus surgery provides significant symptomatic relief and endoscopic healing in patients with CRS and NP.     

鼻内镜手术对成人慢性鼻-鼻窦炎伴哮喘患者疗效的影响

目的　分析并探讨鼻内镜手术对成人慢性鼻-鼻窦炎（chronic rhinosinusitis,CRS）伴哮喘患者疗效的影响。方法　采用前瞻性对照分组设计,对我院诊断为CRS并接受鼻内镜手术治疗的325例患者依入组标准选择92例患者进行跟踪随访,于术前、术后评估所有患者鼻部和哮喘各指标变化情况。结果　共92例完成3个月随访,90例完成12个月随访。鼻内镜手术后鼻部总体症状和鼻塞、流涕的视觉模拟量表评分以及鼻内镜Lund-Kennedy评分均明显改善,喷嚏、嗅功能、头面部疼痛视觉模拟量表评分结果也有不同程度改善。伴哮喘患者鼻内镜手术后哮喘控制测试评分在术后明显升高,而肺功能各指标变化无统计学差异。结论　以鼻内镜手术为中心的综合治疗对成人CRS伴哮喘患者的鼻部症状改善和减少用药量有显著作用;短期内鼻内镜手术对提高哮喘患者哮喘控制水平和减少哮喘用药量有积极作用。     

Utility of a three-item smell identification test in detecting olfactory dysfunction

OBJECTIVE: Physicians rarely assess smell function, largely because of time considerations. Therefore, there is clinical need for very brief cranial nerve I screening tests. Although a few such tests exist, none have been adequately validated. The goal of this study was to empirically assess the utility of a three-item microencapsulated odor identification test in detecting olfactory dysfunction. SETTING: Smell and taste center at a university medical center. METHODS: The test was administered to 224 consecutive patients (98 men and 126 women ranging in age from 15-88 years). As part of their overall assessment, the well-validated 40-item University of Pennsylvania Smell Identification Test (UPSIT) was also administered. Sensitivity, specificity, and both negative and positive predictive values of the three-item test were established relative to UPSIT dysfunction categories. Test-retest reliability was determined in a subset of 39 patients. RESULTS: The three-item test was abnormal in 99% (67/68) of patients with anosmia, 85% (35/41) of those with severe microsmia, 76% (31/41) of those with moderate microsmia, and 50% (17/34) of those with mild microsmia. Of the 40 normosmic patients, 62.5% (25/40) correctly identified all odors, 25% (10/40) two odors, and 12.5% (5/40) one odor. None of the normosmic patients missed all three items. Using a cut-off score of 2, the test's sensitivity and specificity were 99% and 40%, respectively, for detecting total anosmia. The corresponding negative and positive predictive values were 98% and 43%. For detecting anosmia and severe microsmia, these values were 93%, 45%, 88%, and 63%. For detecting any olfactory pathology, they were 82%, 63%, 42%, and 91%. The test-retest reliability was 0.87. CONCLUSION: The brief three-item test used in this study was found to be highly sensitive in identifying olfactory loss in patients with chemosensory complaints, particularly those with severe dysfunction. Although only moderately specific, its high reliability and negative predictive value suggests it may be an appropriate screening test for olfactory loss.     

Predictive factors and outcomes in endoscopic sinus surgery for chronic rhinosinusitis

PURPOSE: To assess objective and quality of life (QOL) outcomes before and after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS) and to determine preoperative factors that predict surgical outcome in these patients. METHODS: One hundred nineteen adult patients with CRS and a mean follow-up of 1.4 +/- 0.35 years were evaluated prospectively including the following patient factors: prior sinus surgery, polyps, asthma, acetylsalicylic acid intolerance (ASA), smoking, allergy, depression, and sex. Computed tomography (CT), endoscopy, and QOL assessment was performed. Predictive value of patient factors was determined based on change in endoscopy and QOL scores after ESS. RESULTS: Objective outcomes: preoperative CT scores were significantly worse in patients with polyps, asthma, and ASA, whereas CT score was unaffected by prior sinus surgery, smoking, allergy, depression, and sex. Patients with CRS demonstrated significant improvement on nasal endoscopy after ESS, but preoperative, postoperative, and change in scores were affected by certain patient factors. Endoscopy scores were significantly worse in patients with prior sinus surgery, polyps, asthma, and ASA, but these patients also experienced the greatest improvement in endoscopy scores. Smokers and patients with depression had the least change in endoscopy scores. QOL outcomes: patients with CRS experienced improvement in QOL after ESS. Pre- and postoperative QOL was positively affected by polyps and adversely affected by ASA, depression, and female sex, but these groups still experienced significant improvement in QOL scores. Pre- and postoperative QOL was unaffected by prior sinus surgery, asthma, smoking, and allergies, and all of these groups experienced significant improvement in QOL scores. Factors predictive of outcome: ASA and depression were predictive of worse outcome. Preoperative CT scores approached significance as being predictive of outcome. CONCLUSION: Surgical management of CRS was associated with significant improvement on objective and QOL measures; however, specific patient factors, in particular ASA and depression, predict poorer outcome. Preoperative CT may be a predictor of endoscopic and QOL outcome and deserves further study.     

Olfactory changes after endoscopic sinus surgery in patients with chronic rhinosinusitis

Objective

To address the controversy over whether olfactory function is improved or not after endoscopic sinus surgery (ESS) in patients with eosinophilic (ECRS) and non-eosinophilic chronic rhinosinusitis (non-ECRS).

Methods

Between June 2006 and March 2012, 89 adult patients with CRS underwent ESS at Hyogo College of Medicine. There were 55 men and 34 women with a mean age of 53 years old, ranging from 23 to 79 years. The average follow-up period was 10.7 months (3–24) after ESS. Peripheral blood examination, sinonasal CT imaging, and four kinds of olfaction tests [self-administered olfaction test (SAOQ), visual analog scale (VAS), T&T recognition threshold tests (T&T) and intravenous olfaction test using prosultiamine] were performed. We diagnosed ECRS when (i) symptoms of nasal congestion and olfactory disorder, (ii) bilateral chronic rhinosinusitis with nasal polyps (CRSwNPs), (iii) peripheral blood eosinophilia (>7.0%), and (iv) ethmoid sinus dominant opacification in preoperative CT findings (i.e. ethmoid sinuses (E) were more bilaterally occupied than those of maxillary sinuses (M), E/M ≥ 1), were completely fulfilled. We divided the patients into two groups of ECRS (group A) and non-ECRS (group B). Olfaction tests before operation, and at the 3rd, 6th, 12th, and 24th month postoperation were analyzed. The severity and therapeutic evaluation of olfaction were based on criteria of T&T recognition thresholds.

Results

The mean SAOQ and VAS scores showed significant improvement within 6 months after ESS in both group A and group B. In total, the improvement rates were 52.0% (26/50) at 3 months, 58.5% (24/41) at 6 months, 40.5% (15/37) at 12 months, and 41.2% (7/17) at 24 months. The significant improvement of T&T recognition thresholds in group B was maintained for 24 months, whereas those in group A, showing transient improvement, deteriorated after 12 months or more. A significant difference in postoperative T&T recognition between groups A and B was found at the 12th postoperative month. In both A and B, 84% of patients had a response to prosultiamine (positive group) in the preoperative stage. T&T thresholds in the positive group were significantly better that those in the negative groups in the postoperative stage.

Conclusion

Olfactory disorders due to ECRS showed transient improvement that deteriorated as time passed after surgery. The olfaction in the non-ECRS patients recovered comparatively well. Postoperative olfactory results were unfavorable in patients without a preoperative reaction to prosultiamine.     

Olfaction in rhinology--methods of assessing the sense of smell

Olfactory disorders frequently occur in rhinological disease. Different subjective and objective test methods are available to assess the sense of olfaction. Among the subjective methods, screening tests and threshold measurements are commonly used to quantify hyposmia or anosmia. Qualitative methods are available using discrimination and identification tests. Objective methods are used in research and in some medicolegal situations. Objective tests include olfactory evoked potentials, functional Magnetic Resonance Imaging and functional Positron Emission Tomography. The measurement of the sense of smell helps to assess the whole spectrum of the effects of nasal disease. This is especially important before rhinological surgery, because a non-detected smell disorder in patients with rhinological disease is common. The assessment of a pre-existing hyposmia or anosmia helps to avoid a postoperative claim that this was caused by surgery. A variety of validated screening tests for olfaction is available and they are a useful tool to document whether a patient is able to smell.     

Quality of life and olfactory outcomes following frontal sinus drill-out procedures

ObjectiveExtensive endoscopic frontal sinus surgery requires drilling of the bone close to the olfactory epithelium and exposing the first olfactory fiber. This study assesses long-term quality of life (QoL) and olfactory outcomes following endoscopic endonasal frontal sinus drill-out procedures.MethodsAll patients who underwent endoscopic endonasal frontal sinus surgery (Draf IIa or Draf III) for chronic rhinosinusitis (CRS) without nasal polyp in 2017 at a single tertiary center were included in the study. Pre- and postoperative scores of SNOT-22, odor identification, discrimination, and threshold were noted.ResultsOf the 31 patients included in this study, Draf IIa and Draf III were performed in 12 (38.7 %) and 19 (61.3 %) patients, respectively. A general assessment of QoL changes was carried out by evaluating pre- and postoperative SNOT-22 scores. A statistically significant difference was found between pre- and postoperative SNOT scores (p < 0.001): SNOT scores decreased by 9.13 units postoperatively. Comparing differences in SNOT-22 and olfactory test scores between Draf IIa and Draf III patients, we did not detect any statistically significant difference between the two procedures (p > 0.05). Draf IIa and Draf III did not display a statistically significant difference in SNOT-22 scores (p = 0.484) and did not have a significant effect on differences in pre- and postoperative identification (p = 0.675), discrimination (p = 0.535), and threshold (p = 0.141) scores.ConclusionsOur study demonstrated that extensive drill-out procedures have not a negative effect on olfactory functions, including threshold scores, in the long term. Patients who underwent frontal sinus procedures for persistent CRS have a better QoL postoperatively. However, more prospective double-blind studies are needed to support our results.     

Comparison of olfactory and taste functions between eosinophilic and non-eosinophilic chronic rhinosinusitis

ObjectiveMost patients with chronic rhinosinusitis (CRS) complain of olfactory and/or taste dysfunctions. However, olfactory and taste dysfunctions depending on the subtype of CRS, classified as eosinophilic CRS (ECRS) and non-eosinophilic CRS (NCRS), have not been clearly reported. Therefore, the purpose of this study was to investigate the clinical features in olfactory and taste functions according to the subtype classified as ECRS and NCRS.MethodsWe retrospectively analyzed the electronic medical records of patients who underwent endoscopic sinus surgery and were diagnosed with CRS. The patients were divided into ECRS and NCRS groups, according to their Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) scores. We analyzed demographic characteristics, Sino-Nasal Outcome Test findings, Lund-Mackay score, and the results of previously-validated tests, including the Korean Version of Sniffin' Stick test and chemical gustatory function test.ResultsPatients with ECRS and NCRS had decreased olfactory and taste functions compared to the control group. In particular, the olfactory score of ECRS patients was lower than that of NCRS patients (18.1 ± 9.5 vs 23.7 ± 8.5, respectively, p <0.001). On the other hand, taste scores of ECRS patients were not statistically different compared to NCRS patients (19.1 ± 4.7 vs. 18.3 ± 4.7, respectively, p = 0.166). Olfactory score decreased with increase in JESREC score (r=-0.203, p = 0.002), but it had no correlation with taste score (r = 0.072, p = 0.276).ConclusionWe found a difference in olfactory function but no difference in taste function between patients in ECRS and NCRS groups. These results may provide valuable clinical features in terms of olfactory and taste functions according to the subtypes of CRS.     

Do patients with chronic rhinosinusitis benefit from consultation with an ENT-doctor?

Conclusion: By consulting an ENT-doctor, patients with chronic rhinosinusitis (CRS), in the general population, receive disease information and adjustment of treatment which can improve disease-specific Quality-of-Life and may improve objective measurements. Objectives: This study aims to follow persons with clinical diagnosed CRS from the general population, to evaluate their benefit from consultation with an ENT-doctor in terms of severity of symptoms and Quality-of-Life. Methods: As part of a trans-European study, selected respondents to a survey questionnaire were invited for a clinical visit. Based on the European Position Paper on Rhinosinusitis and Nasal Polyps, persons were diagnosed with CRS and followed for 2 years. Quality-of-Life was measured using the Sino Nasal Outcome Test 22 and European Quality-of-Life – 5 Dimensions. Clinical examination included rhinoscopy, acoustic rhinometry, peak nasal inspiratory flow, smell test, and skin prick test. Results: Out of 91 persons with CRS, only 42% had previously consulted an ENT-doctor, and 51% were in current treatment for CRS. Most patients were advised medical treatment and 20% underwent surgery. Disease-specific Quality-of-Life, peak nasal inspiratory flow, olfactory function, and the nasal volume significantly increased over the 2-year period.     

The Korean version of the Sniffin' stick (KVSS) test and its validity in comparison with the cross-cultural smell identification test (CC-SIT)

Objective

The Korean Version of the Sniffin’ stick (KVSS) is the first olfactory test for Koreans. Although we adopted the Sniffin’ Stick, we modified it to make it more suitable for Koreans. KVSS I is a screening test, and KVSS II a more comprehensive test. The aims of this study were to apply the KVSS test and assess its clinical validity and reliability in comparison to CC-SIT.

Methods

One hundred and seventy-four healthy volunteers and 206 patients with subjective decreased olfaction participated. Each participant was tested with both the CC-SIT and KVSS tests and then the correlation between these two tests was analyzed.

Results

The correlation between CC-SIT and KVSS I was 0.720 (p < 0.01) and 0.714 between the CC-SIT and KVSS II total scores (p < 0.01). When the degree of olfaction based on the KVSS I was used, the mean CC-SIT score was 8.6±1.8 for normosmia, 7.3±2.2 for hyposmia, and 4.2±2.3 for anosmia. When the KVSS II total was applied, the mean CC-SIT score was 8.4±1.8 for normosmia, 7.3±2.0 for hyposmia, and 3.7±2.0 for anosmia. The means of the three group differed significantly in both cases (p < 0.01).

Conclusion

Thus, the KVSS test demonstrates validity and reliability for Korean in comparison with CC-SIT.