Predictive model for postoperative unrecovered olfactory function in CRSwNP patients with olfactory disorder.

Area of Science:

• Otolaryngology
• Rhinology
• Olfactory dysfunction research

Background:

• Olfactory disorder (OD) is a common and difficult symptom in chronic rhinosinusitis with nasal polyps (CRSwNP).
• Endoscopic sinus surgery (ESS) is a treatment for CRSwNP, but olfactory outcomes can be variable.
• Predicting poor olfactory prognosis after ESS in CRSwNP patients with OD is crucial for management.

Purpose of the Study:

• To identify risk factors for persistent olfactory disorder after ESS in CRSwNP patients.
• To develop a predictive model for poor olfactory prognosis in this patient group.

Main Methods:

• Seventy-eight CRSwNP patients with OD undergoing ESS were studied.
• Olfactory function was assessed preoperatively and 6 months postoperatively using Sniffin' Sticks.
• Logistic regression and ROC curves were used to identify risk factors and develop a predictive model.

Main Results:

• 66.7% of patients had unrecovered olfaction 6 months after ESS.
• Lower preoperative Questionnaire for Olfactory Disorders-Negative Statements (QOD-NS) scores, lower total olfactory cleft scores (TOCS), and fewer tissue eosinophils were associated with unrecovered olfaction.
• A predictive model incorporating QOD-NS, TOCS, and eosinophil count achieved an AUC of 0.845.

Conclusions:

• Preoperative QOD-NS, TOCS, and tissue eosinophil count are independent risk factors for short-term olfactory dysfunction post-ESS in CRSwNP.
• The developed predictive model is practical for early identification of patients with poor olfactory prognosis.
• Early identification allows for timely additional interventions to improve olfactory outcomes.