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Olfactory changes after endoscopic sinus surgery in patients with chronic rhinosinusitis.
Auris Nasus Larynx. 2013 Oct; 40(5):452-7.AN

Abstract

OBJECTIVE

To address the controversy over whether olfactory function is improved or not after endoscopic sinus surgery (ESS) in patients with eosinophilic (ECRS) and non-eosinophilic chronic rhinosinusitis (non-ECRS).

METHODS

Between June 2006 and March 2012, 89 adult patients with CRS underwent ESS at Hyogo College of Medicine. There were 55 men and 34 women with a mean age of 53 years old, ranging from 23 to 79 years. The average follow-up period was 10.7 months (3-24) after ESS. Peripheral blood examination, sinonasal CT imaging, and four kinds of olfaction tests [self-administered olfaction test (SAOQ), visual analog scale (VAS), T&T recognition threshold tests (T&T) and intravenous olfaction test using prosultiamine] were performed. We diagnosed ECRS when (i) symptoms of nasal congestion and olfactory disorder, (ii) bilateral chronic rhinosinusitis with nasal polyps (CRSwNPs), (iii) peripheral blood eosinophilia (>7.0%), and (iv) ethmoid sinus dominant opacification in preoperative CT findings (i.e. ethmoid sinuses (E) were more bilaterally occupied than those of maxillary sinuses (M), E/M≥1), were completely fulfilled. We divided the patients into two groups of ECRS (group A) and non-ECRS (group B). Olfaction tests before operation, and at the 3rd, 6th, 12th, and 24th month postoperation were analyzed. The severity and therapeutic evaluation of olfaction were based on criteria of T&T recognition thresholds.

RESULTS

The mean SAOQ and VAS scores showed significant improvement within 6 months after ESS in both group A and group B. In total, the improvement rates were 52.0% (26/50) at 3 months, 58.5% (24/41) at 6 months, 40.5% (15/37) at 12 months, and 41.2% (7/17) at 24 months. The significant improvement of T&T recognition thresholds in group B was maintained for 24 months, whereas those in group A, showing transient improvement, deteriorated after 12 months or more. A significant difference in postoperative T&T recognition between groups A and B was found at the 12th postoperative month. In both A and B, 84% of patients had a response to prosultiamine (positive group) in the preoperative stage. T&T thresholds in the positive group were significantly better that those in the negative groups in the postoperative stage.

CONCLUSION

Olfactory disorders due to ECRS showed transient improvement that deteriorated as time passed after surgery. The olfaction in the non-ECRS patients recovered comparatively well. Postoperative olfactory results were unfavorable in patients without a preoperative reaction to prosultiamine.

Authors+Show Affiliations

Department of Otolaryngology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23312885

Citation

Oka, Hideki, et al. "Olfactory Changes After Endoscopic Sinus Surgery in Patients With Chronic Rhinosinusitis." Auris, Nasus, Larynx, vol. 40, no. 5, 2013, pp. 452-7.
Oka H, Tsuzuki K, Takebayashi H, et al. Olfactory changes after endoscopic sinus surgery in patients with chronic rhinosinusitis. Auris Nasus Larynx. 2013;40(5):452-7.
Oka, H., Tsuzuki, K., Takebayashi, H., Kojima, Y., Daimon, T., & Sakagami, M. (2013). Olfactory changes after endoscopic sinus surgery in patients with chronic rhinosinusitis. Auris, Nasus, Larynx, 40(5), 452-7. https://doi.org/10.1016/j.anl.2012.12.001
Oka H, et al. Olfactory Changes After Endoscopic Sinus Surgery in Patients With Chronic Rhinosinusitis. Auris Nasus Larynx. 2013;40(5):452-7. PubMed PMID: 23312885.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Olfactory changes after endoscopic sinus surgery in patients with chronic rhinosinusitis. AU - Oka,Hideki, AU - Tsuzuki,Kenzo, AU - Takebayashi,Hironori, AU - Kojima,Yusuke, AU - Daimon,Takashi, AU - Sakagami,Masafumi, Y1 - 2013/01/11/ PY - 2012/05/23/received PY - 2012/12/05/revised PY - 2012/12/19/accepted PY - 2013/1/15/entrez PY - 2013/1/15/pubmed PY - 2014/2/8/medline SP - 452 EP - 7 JF - Auris, nasus, larynx JO - Auris Nasus Larynx VL - 40 IS - 5 N2 - OBJECTIVE: To address the controversy over whether olfactory function is improved or not after endoscopic sinus surgery (ESS) in patients with eosinophilic (ECRS) and non-eosinophilic chronic rhinosinusitis (non-ECRS). METHODS: Between June 2006 and March 2012, 89 adult patients with CRS underwent ESS at Hyogo College of Medicine. There were 55 men and 34 women with a mean age of 53 years old, ranging from 23 to 79 years. The average follow-up period was 10.7 months (3-24) after ESS. Peripheral blood examination, sinonasal CT imaging, and four kinds of olfaction tests [self-administered olfaction test (SAOQ), visual analog scale (VAS), T&T recognition threshold tests (T&T) and intravenous olfaction test using prosultiamine] were performed. We diagnosed ECRS when (i) symptoms of nasal congestion and olfactory disorder, (ii) bilateral chronic rhinosinusitis with nasal polyps (CRSwNPs), (iii) peripheral blood eosinophilia (>7.0%), and (iv) ethmoid sinus dominant opacification in preoperative CT findings (i.e. ethmoid sinuses (E) were more bilaterally occupied than those of maxillary sinuses (M), E/M≥1), were completely fulfilled. We divided the patients into two groups of ECRS (group A) and non-ECRS (group B). Olfaction tests before operation, and at the 3rd, 6th, 12th, and 24th month postoperation were analyzed. The severity and therapeutic evaluation of olfaction were based on criteria of T&T recognition thresholds. RESULTS: The mean SAOQ and VAS scores showed significant improvement within 6 months after ESS in both group A and group B. In total, the improvement rates were 52.0% (26/50) at 3 months, 58.5% (24/41) at 6 months, 40.5% (15/37) at 12 months, and 41.2% (7/17) at 24 months. The significant improvement of T&T recognition thresholds in group B was maintained for 24 months, whereas those in group A, showing transient improvement, deteriorated after 12 months or more. A significant difference in postoperative T&T recognition between groups A and B was found at the 12th postoperative month. In both A and B, 84% of patients had a response to prosultiamine (positive group) in the preoperative stage. T&T thresholds in the positive group were significantly better that those in the negative groups in the postoperative stage. CONCLUSION: Olfactory disorders due to ECRS showed transient improvement that deteriorated as time passed after surgery. The olfaction in the non-ECRS patients recovered comparatively well. Postoperative olfactory results were unfavorable in patients without a preoperative reaction to prosultiamine. SN - 1879-1476 UR - https://www.unboundmedicine.com/medline/citation/23312885/Olfactory_changes_after_endoscopic_sinus_surgery_in_patients_with_chronic_rhinosinusitis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0385-8146(12)00240-4 DB - PRIME DP - Unbound Medicine ER -