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Olfaction after endoscopic sinus surgery: long-term results.

H R Briner¹, N Jones, D Simmen

¹ORL-Zentrum (Center for Otology, Skull Base Surgery, Rhinology and Facial Plastic Surgery), Hirslanden Clinic, Zurich, Switzerland. briner@orlzentrum.com

|May 23, 2012

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Area of Science:

Otolaryngology
Rhinology
Olfactory Neuroscience

Background:

Chronic rhinosinusitis (CRS) frequently causes olfactory dysfunction, impacting patients' quality of life.
Olfactory loss is a primary symptom in CRS, necessitating effective treatment strategies.
Endoscopic sinus surgery (ESS) is a common intervention for CRS, with potential benefits for smell restoration.

Purpose of the Study:

To evaluate the long-term (5-year) effects of ESS combined with topical medical treatment on olfactory function in CRS patients.
To assess both subjective and objective measures of olfaction following surgical intervention for CRS.
To determine the sustained efficacy and potential limitations of ESS in restoring smell over a five-year period.

Main Methods:

Prospective, non-randomized interventional study involving 45 CRS patients undergoing ESS.
Olfactory assessment using a subjective visual analogue scale (VAS).
Objective olfactory testing via Smell Diskettes and quantitative N-Butanol threshold measurement preoperatively and at 3 months and 5 years post-surgery.

Main Results:

Subjective olfaction (VAS) improved in 79% of patients at 5 years.
Objective Smell Diskettes showed improvement in 53% of patients at 5 years.
Quantitative N-Butanol threshold improved in 85% of patients at 5 years, but 9% showed no improvement and 6% experienced deterioration.

Conclusions:

Endoscopic sinus surgery combined with ongoing topical treatment offers significant long-term improvement in olfactory function for most CRS patients.
Objective measures, particularly the N-Butanol threshold, demonstrate sustained olfactory gains over five years.
A subset of patients may not experience olfactory improvement or could even have worsening smell, highlighting the need for thorough preoperative patient counseling regarding potential outcomes.