TY - JOUR
T1 - Factors driving olfactory loss in patients with chronic rhinosinusitis
T2 - a case control study
AU - Schlosser, Rodney J.
AU - Smith, Timothy L.
AU - Mace, Jess C.
AU - Alt, Jeremiah
AU - Beswick, Daniel M.
AU - Mattos, Jose L.
AU - Payne, Spencer
AU - Ramakrishnan, Vijay R.
AU - Soler, Zachary M.
N1 - Funding Information:
sources for the study: National Institutes of Health (NIH) (National Institute on Deafness and Other Communication Disorders [NIDCD] R01 DC005805 [PI: T.L.S./Z.M.S.] to J.A.A., R.J.S., J.C.M., T.L.S., V.R.R., and Z.M.S.). The funding organization did not contribute to the design or conduct of this study, preparation, review, approval, or decision to submit this manuscript for publication.
Publisher Copyright:
© 2020 ARS-AAOA, LLC
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: Olfactory dysfunction (OD) in chronic rhinosinusitis (CRS) is common. It is likely that numerous factors such as sex, race, age, allergies, asthma, smoking, and other comorbidities play a role in CRS-related OD. In order to determine which aspects of OD are due solely to CRS and which are associated with other confounders, control populations are needed to allow appropriate risk assessments. Methods: Prospective, multi-institutional enrollment of patients with CRS and control subjects without CRS was performed. Demographic information, comorbidities, and olfactory testing (Sniffin’ Sticks) of threshold (T), discrimination (D), and identification (I) scores (TDI) was collected. Results: A total of 224 patients with CRS and 164 control subjects were enrolled. Olfaction was worse in CRS patients compared to controls (mean ± standard deviation (SD) TDI = 22.4 ± 9.5 vs 28.8 ± 7.0, respectively, p < 0.001). Only 27% of CRS patients were normosmic compared to 49% of controls (p < 0.001). When stratifying by nasal polyp (NP) status, CRSwNP patients had significant impairments in TDI, T, D, and I compared to controls with mean differences of 11.2, 3.3, 3.5, and 4.4 points, respectively (all p < 0.001). In contrast, CRSsNP patients only had impaired T when compared to controls with a mean difference of 2.2 points (p < 0.001). Multivariate modeling of TDI scoring showed that OD was driven by polyps, asthma, diabetes, and age. CRSsNP was not independently associated with worse TDI scores. Conclusion: OD in CRS patients is multifactorial. Independent drivers appear to be polyp status, asthma, diabetes, and age. OD in patients with CRSsNP is similar to controls with the exception of impaired thresholds.
AB - Background: Olfactory dysfunction (OD) in chronic rhinosinusitis (CRS) is common. It is likely that numerous factors such as sex, race, age, allergies, asthma, smoking, and other comorbidities play a role in CRS-related OD. In order to determine which aspects of OD are due solely to CRS and which are associated with other confounders, control populations are needed to allow appropriate risk assessments. Methods: Prospective, multi-institutional enrollment of patients with CRS and control subjects without CRS was performed. Demographic information, comorbidities, and olfactory testing (Sniffin’ Sticks) of threshold (T), discrimination (D), and identification (I) scores (TDI) was collected. Results: A total of 224 patients with CRS and 164 control subjects were enrolled. Olfaction was worse in CRS patients compared to controls (mean ± standard deviation (SD) TDI = 22.4 ± 9.5 vs 28.8 ± 7.0, respectively, p < 0.001). Only 27% of CRS patients were normosmic compared to 49% of controls (p < 0.001). When stratifying by nasal polyp (NP) status, CRSwNP patients had significant impairments in TDI, T, D, and I compared to controls with mean differences of 11.2, 3.3, 3.5, and 4.4 points, respectively (all p < 0.001). In contrast, CRSsNP patients only had impaired T when compared to controls with a mean difference of 2.2 points (p < 0.001). Multivariate modeling of TDI scoring showed that OD was driven by polyps, asthma, diabetes, and age. CRSsNP was not independently associated with worse TDI scores. Conclusion: OD in CRS patients is multifactorial. Independent drivers appear to be polyp status, asthma, diabetes, and age. OD in patients with CRSsNP is similar to controls with the exception of impaired thresholds.
KW - chemosensory
KW - olfaction
KW - polyp
KW - sinusitis
KW - surgery
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U2 - 10.1002/alr.22445
DO - 10.1002/alr.22445
M3 - Article
C2 - 31899859
AN - SCOPUS:85077290211
SN - 2042-6976
VL - 10
SP - 7
EP - 14
JO - International Forum of Allergy and Rhinology
JF - International Forum of Allergy and Rhinology
IS - 1
ER -