McCann Adam C, Trope Michal, Walker Victoria L, Kavoosi Tazheh A, Speth Marlene M, Gengler Isabelle, Phillips Katie M, Sedaghat Ahmad R
Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
Klinik für Hals-, Nasen-, Ohren- Krankheiten, Hals-und Gesichtschirurgie, Kantonsspital Aarau, Aarau, Switzerland.
Laryngoscope. 2021 Jul;131(7):E2116-E2120. doi: 10.1002/lary.29280. Epub 2020 Dec 10.
OBJECTIVES/HYPOTHESIS: As a cardinal symptom of chronic rhinosinusitis (CRS), hyposmia has been recommended to be assessed as a component of CRS disease control. Herein we determine the significance of hyposmia in CRS in the context of nasal obstruction and drainage symptoms.
Prospective, cross-sectional METHODS: Cross-sectional study of 308 CRS patients (102 CRSwNP, 206 CRSsNP) without prior endoscopic sinus surgery. The burden of nasal obstruction and hyposmia were assessed using the corresponding item scores on the 22-item Sinonasal Outcome Test (SNOT-22). Burden of nasal discharge was assessed using the mean of "thick nasal discharge" and "thick post-nasal discharge" SNOT-22 item scores. Patients were all asked to rate their CRS symptom control as "not at all," "a little," "somewhat," "very," or "completely."
In CRSwNP, only 4.9% had a hyposmia score > 1 with nasal obstruction and drainage scores less than or equal to 1. In CRSsNP, only 1.9% had a hyposmia score > 1 with nasal obstruction and drainage scores less than or equal to 1. On univariate association, CRS symptom control was significantly associated with nasal obstruction, hyposmia, and drainage in both CRSwNP and CRSsNP (P < .05 in all cases). Using multivariable regression to account for all nasal symptoms, only nasal obstruction and nasal discharge scores (but not hyposmia) were significantly associated with CRS symptom control.
Hyposmia rarely occurs without nasal obstruction or nasal drainage, and may therefore be redundant to assess for CRS disease control. Moreover, hyposmia was not associated with patient-reported CRS symptom control when accounting for the burden of nasal obstruction and drainage.
3 Laryngoscope, 131:E2116-E2120, 2021.
目的/假设：嗅觉减退作为慢性鼻-鼻窦炎（CRS）的主要症状，已被推荐作为CRS疾病控制评估的一部分。在此，我们在鼻塞和流涕症状的背景下确定嗅觉减退在CRS中的意义。
前瞻性横断面研究
对308例未接受过内镜鼻窦手术的CRS患者（102例CRSwNP，206例CRSsNP）进行横断面研究。使用22项鼻鼻窦结局测试（SNOT-22）中的相应项目评分评估鼻塞和嗅觉减退的负担。使用“浓稠鼻涕”和“浓稠鼻后滴漏”SNOT-22项目评分的平均值评估鼻涕的负担。所有患者均被要求将其CRS症状控制程度评为“完全没有”“有一点”“有些”“非常”或“完全”。
在CRSwNP中，只有4.9%的患者嗅觉减退评分>1且鼻塞和流涕评分小于或等于1。在CRSsNP中，只有1.9%的患者嗅觉减退评分>1且鼻塞和流涕评分小于或等于1。单因素分析显示，CRSwNP和CRSsNP中CRS症状控制与鼻塞、嗅觉减退和流涕均显著相关（所有情况P<0.05）。使用多变量回归分析所有鼻部症状后，只有鼻塞和流涕评分（而非嗅觉减退）与CRS症状控制显著相关。
嗅觉减退很少在没有鼻塞或流涕的情况下出现，因此对于CRS疾病控制的评估可能是多余的。此外，在考虑鼻塞和流涕负担时，嗅觉减退与患者报告的CRS症状控制无关。
3 喉镜，131:E2116-E2120，2021年。
