Olfactory Outcomes After Endoscopic Sinus Surgery for Chronic Rhinosinusitis With Nasal Polyposis

To evaluate subjective and objective olfactory outcomes in patients undergoing endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyps (CRSwNP).

Prospective, single-center study including adult patients undergoing ESS for CRSwNP from July 2022 to May 2024. Olfactory status was assessed using the Sinonasal Outcome Test (SNOT-22) and Sniffin' Sticks odor identification test preoperatively and at 1-, 3-, and 6-months postoperatively.

Thirty-six patients (45% female, mean age: 48 ± 14) were included. Among them, 47% had asthma, 53% had a history of previous sinus surgery, and 28% had aspirin-exacerbated respiratory disease. Mean SNOT-22 score decreased from 57 ± 20 to 22 ± 18, 15 ± 14, and 25 ± 19, at 1-, 3-, and 6-months postoperatively, respectively (p < 0.001). Mean Sniffin' Sticks identification test score improved from 5.2 ± 4.4 odors identified (out of 16) to 7.9 ± 3.9, 8.3 ± 4.7, and 7.7 ± 4.9 points at 1-, 3-, and 6-months postoperatively, respectively, with statistically significant improvements at 1- and 3-months (p < 0.001) and at 6-months (p = 0.012).

This prospective study demonstrates improvements in subjective and objective measures of olfaction after ESS in patients with CRSwNP. While the sense of smell may be the most difficult symptom to address with surgical intervention, our study provides direct evidence that appropriate surgical intervention can in fact provide meaningful improvements to a large proportion of patients with nasal polyps. Longer-term studies will be required to determine if these improvements will remain sustained.

3.