[The impacts of endoscopic sinus surgery with middle turbinate and superior turbinate resection on quality of life and olfactory function in patients with chronic rhinosinusitis with nasal polyps].

The aim of this study is to investigate the impacts of endoscopic sinus surgery(ESS) with middle turbinate and superior turbinate resection on quality of life and olfactory function in patients with chronic rhinosinusitis with nasal polyps(CRSwNP) and with dysosmia. All of the 81 patients with CRSwNP and with dysosmia recieved ESS with middle turbinate and superior turbinate resection.The patients were given standardized drug treatments during the preoperative period,such as nasal irrigation,using local hormone spray,mucus decorporation agent by oral,using macrolide antibiotics according to the circumstances and so on.We used SNOT-20 to evaluate the quality of life preoperatively and postoperatively in patients;and used the T&T olfactory testing and VAS to evaluate the olfactory function of the patients.The SNOT-20 test showed that "need to blow nose", "lack of a good sleep", "thick nasal discharge", "difficult to go to sleep",and "awkward" influence on the quality of life severely.The scores of all items showed decreasing tread in 2 weeks,1 month and 3 months after operation( <0.05).Olfactory:Among the 81 patients(162 side),54 patients(108 sides) lost sense of smell completely in preoperative period and 27 patients' olfaction lost in varying degrees(10 patients are bilateral symmetry hyposmia and 17 patients are bilateral asymmetry hyposmia).Compared with the preoperative period,70 patients'(86.4%) olfactory function were improved at 3 months after the operation,in which 43 patients'(53.1%) olfactory function recovered to normal,and 27 patients'(33.3%) olfactory function improved in varying degrees;however,11 patients'(13.6%) olfactory function had not improvement at all.Sixty-one patients were followed up for more than one year.One year after operation,53 patients'(86.9%) olfactory function were improved,in which the 31 patients' (50.8%) olfactory function recovered to normal and 22 patients'(36.1%)olfactory function improved in varying degrees;8 patients'(13.1%) olfactory function had no improvement;the remaining 20 patients are being followed up.There was a significant difference between preoperative T&T olfactory testing and postoperative's( <0.05);and so was VAS assessment( <0.05). For the patients with CRSwNP and with dysosmia,the operation of ESS with middle turbinate and superior turbinate resection combined with standardized drug treatment in preoperative period can effectively improve the patients' quality of life and olfactory function.Hyperventilation and nasal dryness caused by excessive resection were not found.