Mattos Jose L, Schlosser Rodney J, Storck Kristina A, Soler Zachary M
Division of Rhinology and Sinus Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC.
Department of Surgery, Ralph H. Johnson VA Medical Center, Charleston, SC.
Int Forum Allergy Rhinol. 2017 Jul;7(7):734-740. doi: 10.1002/alr.21940. Epub 2017 May 18.
Chronic rhinosinusitis (CRS) significantly impacts olfaction. However, the relationship between objective olfaction and patient-reported olfactory-specific quality of life (QOL) is not well understood. Furthermore, objective olfactory testing can be time consuming, so we sought to determine if patient-reported olfactory QOL can be used as screening tool for olfactory dysfunction.
Olfactory dysfunction was evaluated in 109 patients with CRS using the Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS) and the Sniffin' Sticks Test, assessing for olfactory threshold, discrimination, identification, and overall composite scores (TDI; composite score of threshold, discrimination, and identification). Regression analysis was performed to correlate olfactory metrics and patient and disease-specific factors with QOD-NS scores. Optimal QOD-NS scores to classify patients based upon objective olfactory function were established.
Bivariate and multivariate regression analyses of QOD-NS and CRS-associated comorbidities, objective measures of disease, demographics, and CRS-specific QOL were performed. Non-white race, depression, and worse 22-item Sino-Nasal Outcome Test (SNOT-22) scores correlated with worse QOD-NS scores (p < 0.005). Worse TDI scores correlated with worse QOD-NS scores, and discrimination had the strongest correlation (p < 0.001). Mean ± standard deviation (SD) QOD-NS scores for normosmia, hyposmia, and anosmia were 44 ± 7.2, 35.7 ± 12.8, and 31.6 ± 10.7, respectively. Receiver operating characteristic curve analysis revealed an area under the curve of 0.770 (p < 0.001), and a QOD-NS cutoff of 38.5 to have maximal Youden's index to define normal vs abnormal TDI score.
In CRS, QOD-NS correlates with non-white race, depression, SNOT-22, and TDI score, with discrimination having the strongest correlation. The QOD-NS also appears to be a feasible tool for olfaction screening.
慢性鼻-鼻窦炎（CRS）对嗅觉有显著影响。然而，客观嗅觉与患者报告的嗅觉特异性生活质量（QOL）之间的关系尚不清楚。此外，客观嗅觉测试可能耗时较长，因此我们试图确定患者报告的嗅觉QOL是否可作为嗅觉功能障碍的筛查工具。
使用嗅觉障碍问卷-否定陈述（QOD-NS）和嗅觉棒测试对109例CRS患者的嗅觉功能障碍进行评估，评估嗅觉阈值、辨别力、识别力和总体综合评分（TDI；阈值、辨别力和识别力的综合评分）。进行回归分析以关联嗅觉指标、患者及疾病特异性因素与QOD-NS评分。确定基于客观嗅觉功能对患者进行分类的最佳QOD-NS评分。
对QOD-NS与CRS相关合并症、疾病的客观指标、人口统计学特征以及CRS特异性QOL进行了双变量和多变量回归分析。非白种人、抑郁症以及较差的22项鼻鼻窦结局测试（SNOT-22）评分与较差 的QOD-NS评分相关（p < 0.005）。较差的TDI评分与较差的QOD-NS评分相关，其中辨别力的相关性最强（p < 0.001）。嗅觉正常、嗅觉减退和嗅觉丧失患者的QOD-NS评分均值±标准差（SD）分别为44 ± 7.2、35.7 ± 12.8和31.6 ± 10.7。受试者工作特征曲线分析显示曲线下面积为0.770（p < 0.001），QOD-NS临界值为38.5时Youden指数最大，可用于定义TDI评分正常与异常。
在CRS中，QOD-NS与非白种人、抑郁症、SNOT-22以及TDI评分相关，其中辨别力的相关性最强。QOD-NS似乎也是一种可行的嗅觉筛查工具。
