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Olfaction Now and in the Future in CRSwNP
Hannan A Qureshi1, Andrew P Lane1
1Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
American Journal of Rhinology & Allergy
|February 27, 2023
Summary
Chronic rhinosinusitis with nasal polyposis (CRSwNP) causes smell loss through obstruction and inflammation. Biologics like dupilumab offer durable improvements, but long-term effects of other therapies require further study.
Area of Science:
- Otolaryngology
- Neuroscience
- Immunology
Background:
- Chronic rhinosinusitis (CRS) is a primary cause of olfactory dysfunction.
- Olfactory dysfunction is significantly more prevalent in CRS with nasal polyposis (CRSwNP) patients.
Approach:
- Comprehensive literature review focusing on CRSwNP and olfactory dysfunction.
- Evaluation of current evidence on mechanisms of smell loss and therapeutic impacts.
Key Points:
- Olfactory dysfunction in CRSwNP involves both conductive (obstructive) and sensorineural (inflammatory) components.
- Oral steroids and endoscopic sinus surgery show short-term olfactory improvement, with uncertain long-term efficacy.
- Biologic therapies, including dupilumab, demonstrate significant and lasting improvements in smell loss for CRSwNP.
Conclusions:
- Olfactory dysfunction is common in CRSwNP.
- Understanding the role of type 2 inflammation in the olfactory epithelium is crucial for developing targeted therapies.
- Further research into cellular and molecular mechanisms is needed to improve treatments for smell loss in CRSwNP.
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