Alobid I, Calvo-Henríquez C, Viveros-Díez P, López-Chacón M, Rojas-Lechuga M J, Langdon C, Marin C, Mullol J
Skull Base Unit, ENT Department, Hospital Clínic Barcelona, IDIBAPS, Barcelona University, Barcelona, Catalonia, Spain.
INGENIO, IRCE, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
J Investig Allergol Clin Immunol. 2024 Dec 5;34(6):377-384. doi: 10.18176/jiaci.0937. Epub 2023 Sep 6.
The diagnostic criteria of chronic rhinosinusitis with nasal polyps (CRSwNP) include olfactory dysfunction. We hypothesize that patients with CRSwNP can self-assess their sense of smell better using a visual analog scale (VAS) than using smell tests.
A controlled cross-sectional study was performed. Adults diagnosed with severe CRSwNP waiting for endoscopic sinus surgery were included. A cohort of healthy controls was also studied. All participants completed the Barcelona Smell Test 24 (BAST-24), the 22-item Sinonasal Outcomes Test 22 (SNOT-22), and a VAS for loss of smell. Patients with CRSwNP underwent blood testing (eosinophil count, total serum IgE), computed tomography (Lund-Mackay Score), and nasal endoscopy.
The study population comprised 138 patients with severe CRSwNP and 40 controls. The BAST-24 identification score was strongly correlated with the VAS score in the CRSwNP group (p=-0.79, P<.001) but not in the control group (p=-0.14; P=.39), this difference between groups being statistically significant (P<.001). A significant correlation was found between SNOT-22 item 21 (loss of smell) and BAST-24 identification (p=-0.65, P<.001), this difference being statistically significant (Z=-2.43; P=.015). The area under the receiver operating curve was 0.85, with 72.5% sensitivity and 93.1% specificity.
This study demonstrates a potential role of the VAS score for the screening of olfactory dysfunction in severe CRSwNP in daily clinical practice.
伴有鼻息肉的慢性鼻-鼻窦炎（CRSwNP）的诊断标准包括嗅觉功能障碍。我们假设，与嗅觉测试相比，CRSwNP患者使用视觉模拟量表（VAS）能更好地自我评估嗅觉。
进行了一项对照横断面研究。纳入等待内镜鼻窦手术的成年重度CRSwNP患者。还研究了一组健康对照者。所有参与者均完成了巴塞罗那嗅觉测试24项（BAST - 24）、22项鼻鼻窦结局测试22项（SNOT - 22）以及嗅觉丧失的VAS。CRSwNP患者接受了血液检测（嗜酸性粒细胞计数、总血清IgE）、计算机断层扫描（Lund - Mackay评分）和鼻内镜检查。
研究人群包括138例重度CRSwNP患者和40例对照者。CRSwNP组中，BAST - 24识别分数与VAS分数显著相关（p = - 0.79，P <.001），而对照组中无显著相关性（p = - 0.14；P =.39），两组间差异具有统计学意义（P <.001）。发现SNOT - 22第21项（嗅觉丧失）与BAST - 24识别之间存在显著相关性（p = - 0.65，P <.001），该差异具有统计学意义（Z = - 2.43；P =.015）。受试者工作特征曲线下面积为0.85，敏感性为72.5%，特异性为93.1%。
本研究证明了VAS分数在日常临床实践中对重度CRSwNP嗅觉功能障碍筛查的潜在作用。
