Chronic Sinusitis With Nasal Polyps and Olfactory Dysfunction: Comparing Olfactory Training and Glucocorticoid
Zhiqiang Zhang1,2,3, Junhao Tu1, Binxiang Tang1
1Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
The Laryngoscope
|April 23, 2025
Summary
Glucocorticoids (GC) combined with olfactory training (OT) improved olfactory function in chronic rhinosinusitis patients. This combination therapy was particularly effective in reducing olfactory fluctuations in eosinophilic chronic rhinosinusitis with nasal polyps.
Area of Science:
- Otolaryngology
- Rhinology
- Allergy and Immunology
Background:
- Chronic rhinosinusitis with nasal polyps (CRSwNP) often presents with olfactory dysfunction (OD).
- Limited comparative data exists for olfactory training (OT) and glucocorticoids (GC) in CRSwNP phenotypes with OD.
Purpose of the Study:
- To evaluate the comparative effectiveness of GC and OT on olfactory dysfunction (OD) in patients with eosinophilic (ECRSwNP) and non-eosinophilic (NonECRSwNP) chronic rhinosinusitis with nasal polyps (CRSwNP).
Main Methods:
- Post-surgery patients with OD were randomized to GC, OT, or combined GC and OT (GCwOT).
- Phenotypic stratification was based on tissue eosinophil percentage (>10% for ECRSwNP).
- Olfactory function (TDIS), quality of life (SNOT-22), endoscopic scores (LKES), and olfactory fluctuations (OF) were assessed at 1, 3, and 6 months.
Main Results:
- Both GC and OT improved SNOT-22 and LKES over time.
- GCwOT showed superior TDIS improvement at 1 month compared to GC or OT alone.
- GCwOT demonstrated sustained TDIS improvement and reduced OF in ECRSwNP patients at 3 and 6 months.
Conclusions:
- Combined GC and OT therapy effectively enhances olfactory function in CRSwNP patients.
- GCwOT significantly reduces olfactory fluctuations, particularly in the ECRSwNP phenotype.
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