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The process of olfaction, also known as the sense of smell, is a sophisticated chemical response system. The specialized sensory neurons that facilitate this process, known as olfactory receptor neurons, are situated in an upper segment of the nasal cavity, known as the olfactory epithelium. Olfactory sensory neurons are bipolar, with their dendrites extending from the epithelium's apex into the mucus that lines the nasal cavity. Airborne molecules, when inhaled, traverse the olfactory...

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Central Compartment Atopic Disease and Its Surgical Outcomes: Olfactory Changes and Technical Notes.

Sheng-Kai Huang, Ching-Hung Hsieh, Ming-Chian Weng

¹Department of Otolaryngology, Kuang-Tien General Hospital, Taichung, Taiwan.

Therapeutic Advances in Allergy and Rhinology

|December 6, 2023

Summary

Central compartment atopic disease (CCAD) significantly impairs smell. Functional endoscopic sinus surgery (FESS) effectively improves olfactory function in CCAD patients, with precise polyp removal crucial for optimal outcomes.

Keywords:

central compartment atopic syndrome chronic rhinosinusitis functional endoscopic sinus surgery

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Area of Science:

Otolaryngology
Immunology
Rhinology

Background:

Central compartment atopic disease (CCAD) is a novel phenotype of chronic rhinosinusitis.
Olfactory function in CCAD patients is not well-studied.
CCAD is associated with allergic responses and eosinophilic inflammation.

Purpose of the Study:

To investigate olfactory function changes following functional endoscopic sinus surgery (FESS) in CCAD patients.
To identify surgical techniques that enhance postoperative olfactory outcomes in CCAD.
To analyze the correlation between olfactory improvement and patient demographics/biomarkers.

Main Methods:

Retrospective cohort study of 23 CCAD patients undergoing FESS.
Analysis of demographic data, olfactory function (using TIBSIT), and serum/tissue eosinophil percentages.
Data collected between June 2018 and December 2021 in Taiwan.

Main Results:

Significant improvement in olfactory function post-FESS (mean TIBSIT score increased from 12.8 to 29.2, P < .0001).
Most patients (95%) had positive aeroallergen reactions; 8.7% had asthma.
Peripheral eosinophilia (43.5%) and eosinophilic nasal polyps (39%) were common.
Olfactory improvement did not correlate with age, serum eosinophils, or polyp eosinophil counts.

Conclusions:

CCAD is strongly linked to olfactory dysfunction.
FESS is an effective treatment for improving olfactory function in CCAD patients.
Precise polyp removal from the olfactory cleft is recommended to optimize surgical outcomes.