Can surgeons predict the olfactory outcomes after endoscopic surgery for nasal polyposis?

Area of Science:

• Otolaryngology
• Rhinology
• Olfactory dysfunction research

Background:

• Nasal polyposis (NP) frequently impairs olfactory function.
• Surgical outcomes for NP, particularly olfactory recovery, can be variable.
• Predictors of olfactory outcomes after ethmoid labyrinth surgery for NP require further elucidation.

Purpose of the Study:

• To identify predictors of olfactory outcomes in patients with nasal polyposis (NP) undergoing ethmoid labyrinth surgery.
• To evaluate the impact of olfactory cleft (OC) polyp resection on olfactory function.
• To assess the influence of prior surgical history on postoperative olfaction.

Main Methods:

• Prospective study of 96 patients with NP undergoing endoscopic ethmoid labyrinth surgery.
• Olfactory function assessed preoperatively and 6 weeks postoperatively using Sniffin' Sticks tests and visual analog scale.
• Multivariate logistic regression analysis to determine independent predictors of olfactory outcomes.

Main Results:

• 47.83% of patients with preoperative hyposmia/anosmia showed improved olfactory function post-surgery.
• History of previous sinus surgery was a significant predictor of poor olfactory outcomes (aOR=4.14, P=.017).
• Histopathology of OC lesions and resection of moderate/large OC lesions did not predict olfactory outcomes.

Conclusions:

• Previous sinus surgery is a strong negative predictor for olfactory recovery after NP surgery.
• Each prior sinus surgery decreases the likelihood of olfactory function improvement with subsequent surgical interventions.
• Surgical history is a critical factor to consider when managing patients with NP and olfactory dysfunction.