Huang Sheng-Kai, Hsieh Ching-Hung, Weng Ming-Chian, Lai Jen-Tsung, Shen Ping-Hung
Department of Otolaryngology, Kuang-Tien General Hospital, Taichung, Taiwan.
Ther Adv Allergy Rhinol. 2023 Dec 3;14:27534030231217423. doi: 10.1177/27534030231217423. eCollection 2023 Jan-Dec.
Central compartment atopic disease (CCAD) is a recent, novel phenotype of chronic rhinosinusitis. Only a few studies have assessed olfactory function in patients with CCAD.
We aimed to investigate olfactory function changes after functional endoscopic sinus surgery (FESS) in patients with CCAD and proposed some surgical techniques to enhance the postoperative olfactory outcomes in such patients.
A retrospective cohort study.
We collected data from 23 patients (8 men and 15 women) with CCAD who underwent FESS performed by a surgeon in Taiwan, between June 2018 and December 2021. The demographic data, olfactory function, and serum and tissue eosinophil percentages of the included patients were analyzed. The Top International Biotech Smell Identification Test (TIBSIT; Top International Biotech, Taipei, Taiwan) was used to assess olfactory function.
Of the 23 patients, most (95%) showed a positive reaction to aeroallergens, and 2 patients (8.7%) had asthma. Ten patients (43.5%) had peripheral eosinophilia, and 9 (39%) had eosinophilic nasal polyps. Moreover, the patients presented with variable olfactory dysfunction; the mean preoperative TIBSIT (pr-TIBSIT) score was 12.8 ± 2.3 (range: 0-43), whereas the mean postoperative TIBSIT (po-TIBSIT) score was 29.2 ± 1.9 (range: 16-44). The po-TIBSIT score was significantly better than the pre-TIBSIT score (paired test, < .0001). The improvement in olfactory function was not significantly correlated with the patients' age, serum eosinophil percentages, and nasal polyp eosinophil counts.
Our findings indicate that CCAD is significantly associated with olfactory dysfunction and that FESS can effectively improve olfactory function. To optimize postoperative olfactory outcomes, precise removal of polyps from the olfactory cleft without damaging the neuroepithelium is recommended. Our study provides valuable insights into the management of CCAD patients undergoing FESS and can guide surgical decision-making to achieve optimal olfactory function outcomes.
中央区特应性疾病（CCAD）是慢性鼻-鼻窦炎的一种新的表型。仅有少数研究评估了CCAD患者的嗅觉功能。
我们旨在研究CCAD患者功能性鼻内镜鼻窦手术（FESS）后的嗅觉功能变化，并提出一些手术技巧以改善此类患者的术后嗅觉效果。
一项回顾性队列研究。
我们收集了2018年6月至2021年12月间在台湾由一名外科医生为23例CCAD患者实施FESS的数据。分析纳入患者的人口统计学数据、嗅觉功能以及血清和组织嗜酸性粒细胞百分比。采用国际顶尖生物技术嗅觉识别测试（TIBSIT；台湾台北国际顶尖生物技术公司）评估嗅觉功能。
23例患者中，大多数（95%）对空气变应原呈阳性反应，2例（8.7%）患有哮喘。10例患者（43.5%）有外周嗜酸性粒细胞增多，9例（39%）有嗜酸性鼻息肉。此外，患者存在不同程度的嗅觉功能障碍；术前TIBSIT（pr-TIBSIT）平均评分为12.8±2.3（范围：0 - 43），而术后TIBSIT（po-TIBSIT）平均评分为29.2±1.9（范围：16 - 44）。po-TIBSIT评分显著优于术前TIBSIT评分（配对检验，P < 0.0001）。嗅觉功能的改善与患者年龄、血清嗜酸性粒细胞百分比及鼻息肉嗜酸性粒细胞计数无显著相关性。
我们的研究结果表明，CCAD与嗅觉功能障碍显著相关，FESS可有效改善嗅觉功能。为优化术后嗅觉效果，建议在不损伤神经上皮的情况下精确切除嗅裂息肉。我们的研究为接受FESS的CCAD患者的管理提供了有价值的见解，并可指导手术决策以实现最佳嗅觉功能结果。
