[Sense of smell before and after endonasal surgery in chronic sinusitis with polyps]

Although olfactory dysfunction is a common clinical symptom in patients with chronic sinusitis, there are few written reports about the nature, frequency and therapeutic accessibility of the various dysosmias. We analysed pre- and postoperative olfactory function in 78 patients suffering from chronic sinusitis with nasal polyposis. Using a squeeze bottle technique we were able to detect preoperative hyposmia and/or dysfunction of olfactory discrimination in 40% and anosmia in 36%. Only 22% of these patients complained spontaneously of disabilities in smell. Endoscopic surgery improved hyposmias and anosmias in 71% and preoperative dysfunctions of olfactory discrimination in 61%. Postoperative thresholds for 2-phenylethanol and dimethyldisulfide worsened in 9% of all patients. Postoperative olfactory discrimination deteriorated in 11%. Preoperative and postoperative olfactory functions were not predictable in individual cases when nasal polyposis was limited. However, mechanical blockage of the nasal airway was just one of many other pathophysiological factors causing olfactory loss in patients with chronic sinusitis.