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Risk factors for olfactory dysfunction in chronic rhinosinusitis.

Eri Mori1, Yoshinori Matsuwaki, Chieko Mitsuyama

  • 1Department of Otorhinolaryngology, Jikei University, School of Medicine, Tokyo, Japan. morieri@jikei.ac.jp

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Olfactory dysfunction is more common and severe in eosinophilic chronic rhinosinusitis (ECRS) than noneosinophilic (NECRS). Key factors include polyps, ethmoid opacification, asthma, smoking, and age, especially in ECRS patients.

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Area of Science:

  • Otorhinolaryngology
  • Immunology
  • Pulmonology

Background:

  • Olfactory dysfunction is a significant symptom in chronic rhinosinusitis (CRS).
  • Distinguishing between eosinophilic CRS (ECRS) and noneosinophilic CRS (NECRS) is crucial as their pathologies and clinical presentations may differ.
  • Previous studies often did not differentiate between ECRS and NECRS, limiting understanding of olfactory dysfunction specific to each subtype.

Purpose of the Study:

  • To investigate the clinical characteristics associated with olfactory dysfunction in Japanese patients with ECRS and NECRS.
  • To compare the prevalence and severity of olfactory dysfunction between ECRS and NECRS cohorts.
  • To identify specific risk factors for olfactory dysfunction within each CRS subtype.

Main Methods:

  • A prospective, multicenter cohort study involving 418 CRS patients from 3 tertiary care centers.
  • Olfactory function was assessed using T&T olfactometry, the Alinamin test (intravenous olfactory test), and Likert scales.
  • Data on demographics, clinical factors, and comorbidities were collected and analyzed using univariate and multivariate statistical methods.

Main Results:

  • Olfactory dysfunction was found to be more prevalent and severe in ECRS compared to NECRS.
  • In CRS overall, olfactory dysfunction was associated with olfactory cleft polyps, ethmoid opacification, asthma, current smoking, and age ≥50 years.
  • Specific risk factors for olfactory dysfunction in NECRS included ethmoid opacification and olfactory cleft polyps. In ECRS, risk factors included olfactory cleft polyps, current smoking, IgE levels ≥400 IU/ml, ethmoid opacification, and asthma.

Conclusions:

  • Olfactory dysfunction is significantly more severe and prevalent in ECRS than in NECRS.
  • Clinicians should consider these clinical findings for diagnosing olfactory dysfunction, particularly in ECRS patients.
  • Advising patients, especially smokers, to quit smoking is recommended to help prevent or manage olfactory dysfunction.