Olfactory cleft and sinus opacification differentially impact olfaction in chronic rhinosinusitis

Area of Science:

• Otolaryngology
• Rhinology
• Olfactory Research

Background:

• Olfactory cleft (OC) opacification is linked to smell dysfunction in chronic rhinosinusitis (CRS).
• Previous findings on this correlation in CRS patients without nasal polyps remain inconclusive.
• Understanding these relationships is crucial for managing olfactory deficits in CRS.

Purpose of the Study:

• To investigate the association between OC opacification, sinus opacification, and olfactory function in CRS patients.
• To differentiate these associations based on the presence or absence of nasal polyps.

Main Methods:

• 148 CRS patients (73 CRSsNP, 75 CRSwNP) and 30 controls underwent olfactory testing (Sniffin' Sticks, QOD-NS).
• CT scans were analyzed for OC opacification and Lund-Mackay scores.
• Correlation analyses were performed between opacification measures and olfactory scores.

Main Results:

• CRS patients showed significantly higher OC opacification than controls (63.7% vs 47.1%).
• Overall, OC opacification correlated with olfactory function (TDI and QOD-NS scores).
• In CRS with nasal polyps (CRSwNP), OC opacification strongly correlated with smell loss (TDI), unlike in CRS without nasal polyps (CRSsNP).
• Lund-Mackay scores correlated with olfactory function in both CRSsNP and CRSwNP groups.

Conclusions:

• CT-assessed sinus opacification impacts olfactory dysfunction differently depending on nasal polyp status.
• Smell loss in CRSwNP is associated with both OC opacification and Lund-Mackay scores.
• In CRSsNP, olfactory dysfunction correlates only with Lund-Mackay scores, suggesting distinct pathophysiological mechanisms.