Discrepancies between subjective and objective olfactory outcomes after FESS in CRSwNP: Predictive factors and...

Area of Science:

• Otolaryngology
• Rhinology
• Olfactory Neuroscience

Background:

• Chronic rhinosinusitis with nasal polyps (CRSwNP) often impairs sense of smell.
• Functional endoscopic sinus surgery (FESS) is performed to improve olfaction in CRSwNP patients.
• Predicting FESS outcomes for smell dysfunction is challenging due to subjective-objective test discrepancies.

Purpose of the Study:

• Identify preoperative factors linked to discrepancies between subjective and objective olfactory outcomes post-FESS.
• Improve patient counseling and outcome prediction for CRSwNP treated with FESS.

Main Methods:

• Retrospective analysis of 100 CRSwNP patients (excluding COVID-19 related olfactory loss) undergoing FESS.
• Data included demographics, sinonasal scores, blood eosinophils, IgE, and olfactory tests (butanol threshold test [BTT], subjective scales).
• Logistic regression analyzed preoperative factors predicting discrepancies between postoperative subjective and objective olfactory function.

Main Results:

• Preoperative BTT scores and parosmia status predicted objective olfactory outcomes.
• Subjective outcomes were influenced by preoperative subjective scores, eosinophil percentage, and parosmia.
• Lower preoperative subjective olfactory scores significantly predicted discrepancies between subjective and objective outcomes (OR=0.335).

Conclusions:

• Discrepancies between subjective and objective olfactory results are common after FESS in CRSwNP.
• Severe preoperative subjective olfactory dysfunction is a key predictor of these discrepancies.
• Combined psychophysical and subjective olfactory assessments are crucial for evaluating FESS outcomes and patient counseling.