Smell impairment in chronic rhinosinusitis – evaluation of endoscopic sinus surgery results and review of literature concerning olfactory function predictors.

INTRODUCTION

Endoscopic sinus surgery (ESS) is the treatment of choice for patients with chronic rhinosinusitis (CRS) refractory to medical therapy. ESS successfully reduces most symptoms of CRS, but its effect on olfaction is always uncertain.

AIM OF THE STUDY

The aim of this study was to assess the influence of sinus surgery on olfaction and to analyze the predictors of olfactory function before and after ESS in the context of a literature review.

MATERIAL AND METHODS

The study group comprised of 153 patients with CRS refractory to medical treatment. The patients evaluated their olfactory function before ESS, 3-6 months after ESS (121 individuals) and 12 months after ESS (58 individuals). Statistical analysis concerned the postoperative olfactory improvement as well as the influence of various predictors on the impairment of smell before and after surgery.

RESULTS AND CONCLUSIONS

Olfactory dysfunction was significantly reduced after ESS. The smell impairment before and after surgery depended on different predictors. Patients with severe preoperative olfactory dysfunction and extensive pathological changes in the nose and sinuses, including nasal polyps, reported most pronounced improvement after ESS. However, severely hyposmic subjects with nasal polyposis, asthma or aspirin intolerance as well as older patients reported worse postoperative smell scores.