Olfactory dysfunction in sinusitis with infiltration of numerous activated eosinophils.

Area of Science:

• Otorhinolaryngology
• Immunology
• Radiology

Background:

• Sinusitis is a common condition affecting the nasal passages and sinuses.
• Eosinophilic inflammation plays a significant role in chronic sinusitis.
• Olfactory dysfunction is a frequent symptom impacting quality of life.

Purpose of the Study:

• To correlate activated eosinophil counts in ethmoidal sinus mucosa with CT findings.
• To assess the relationship between eosinophil levels and olfactory dysfunction severity.
• To explore clinical characteristics associated with eosinophilic sinusitis.

Main Methods:

• Ethmoidal sinus mucosal specimens were analyzed from 84 patients undergoing endoscopic sinus surgery (ESS).
• Activated eosinophils were quantified using EG2 antibody staining.
• Nasal symptoms, CT scans, and olfactory function (T&T olfactometry, Alinamin test) were evaluated.

Main Results:

• A high percentage of activated eosinophils (EG2-positive cells) was associated with significant differences in 'problems of smell' and ethmoidal sinus CT findings.
• Olfactory dysfunction can occur even with low CT scores in patients with high eosinophil counts.
• Postoperative assessment showed olfactory dysfunction correlates with aggravated sinonasal lesions.

Conclusions:

• Diagnosis of sinusitis with severe eosinophilic infiltration requires evaluation beyond blood/tissue eosinophil counts.
• CT scan findings of ethmoidal sinus lesions and the presence of olfactory dysfunction are crucial diagnostic indicators.
• Integrated assessment of clinical, radiological, and functional parameters is essential for managing eosinophilic sinusitis.