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Validation of a Visual Analog Scale for Loss of Smell as a Quick Test in Chronic Rhinosinusitis With Nasal Polyps
I Alobid1,2,3, C Calvo-Henríquez4,5, P Viveros-Díez6
1Skull Base Unit, ENT Department, Hospital Clínic Barcelona, IDIBAPS, Barcelona University, Barcelona, Catalonia, Spain.
Background And Objectives:
The diagnostic criteria of chronic rhinosinusitis with nasal polyps (CRSwNP) include olfactory dysfunction. We hypothesize that patients with CRSwNP can self-assess their sense of smell better using a visual analog scale (VAS) than using smell tests.
Methods:
A controlled cross-sectional study was performed. Adults diagnosed with severe CRSwNP waiting for endoscopic sinus surgery were included. A cohort of healthy controls was also studied. All participants completed the Barcelona Smell Test 24 (BAST-24), the 22-item Sinonasal Outcomes Test 22 (SNOT-22), and a VAS for loss of smell. Patients with CRSwNP underwent blood testing (eosinophil count, total serum IgE), computed tomography (Lund-Mackay Score), and nasal endoscopy.
Results:
The study population comprised 138 patients with severe CRSwNP and 40 controls. The BAST-24 identification score was strongly correlated with the VAS score in the CRSwNP group (p=-0.79, P<.001) but not in the control group (p=-0.14; P=.39), this difference between groups being statistically significant (P<.001). A significant correlation was found between SNOT-22 item 21 (loss of smell) and BAST-24 identification (p=-0.65, P<.001), this difference being statistically significant (Z=-2.43; P=.015). The area under the receiver operating curve was 0.85, with 72.5% sensitivity and 93.1% specificity.
Conclusion:
This study demonstrates a potential role of the VAS score for the screening of olfactory dysfunction in severe CRSwNP in daily clinical practice.
