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Corticosteroid responsive olfactory dysfunction in chronic rhinosinusitis: what does it mean?

K A Archer1, J C Mace2, T L Smith2

  • 1Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.

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|September 19, 2025
PubMed
Summary
This summary is machine-generated.

Patients with chronic rhinosinusitis (CRS) and corticosteroid-responsive olfactory dysfunction (CROD) show better post-operative olfactory improvement. This indicates corticosteroid responsiveness is a predictor of preserved function and reversibility in CRS patients.

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Area of Science:

  • Otolaryngology
  • Rhinology
  • Olfactory dysfunction research

Background:

  • Chronic rhinosinusitis (CRS) often involves olfactory dysfunction.
  • Corticosteroid treatment can improve olfaction in CRS, suggesting reversibility.
  • Pre-operative olfactory assessment is crucial for predicting surgical outcomes.

Purpose of the Study:

  • To determine if self-reported pre-operative corticosteroid-responsive olfactory dysfunction (CROD) predicts post-operative olfactory improvement in CRS patients undergoing sinus surgery.
  • To evaluate CROD as a prognostic factor for olfactory recovery after surgery.

Main Methods:

  • Prospective, observational study of 253 refractory CRS patients with pre-operative olfactory dysfunction.
  • Patients categorized as corticosteroid-responsive or non-responsive based on survey.
  • Olfactory outcomes assessed using Sniffin Sticks, OCES, QOD-NS, and SNOT-22 pre- and post-operatively.

Main Results:

  • Patients with CROD were more likely to have comorbidities like nasal polyposis, asthma, and aspirin sensitivity.
  • CROD group demonstrated significantly better post-operative improvement in Olfactory Cleft Endoscopy Score (OCES) and Questionnaire of Olfactory Disorders (QOD-NS) scores.
  • These findings highlight a correlation between corticosteroid responsiveness and enhanced olfactory recovery.

Conclusions:

  • Corticosteroid responsiveness is a valuable clinical predictor of preserved olfactory function and reversibility in CRS patients.
  • Self-reported CROD can serve as a simple prognostic factor for predicting post-operative olfactory improvement.
  • This research supports the use of corticosteroid response assessment in managing olfactory dysfunction in CRS.