Factors driving olfactory loss in patients with chronic rhinosinusitis: a case control study

Rodney J. Schlosser, Timothy L. Smith, Jess C. Mace, Jeremiah Alt, Daniel M. Beswick, Jose L. Mattos, Spencer Payne, Vijay R. Ramakrishnan, Zachary M. Soler

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)7-14
Number of pages8
JournalInternational Forum of Allergy and Rhinology
Volume10
Issue number1
DOIs
StatePublished - Jan 1 2020

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Case-Control Studies
Asthma
Polyps
Comorbidity
Nasal Polyps
Smell
Hypersensitivity
Smoking
Demography
Population

Keywords

  • chemosensory
  • olfaction
  • polyp
  • sinusitis
  • surgery

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Factors driving olfactory loss in patients with chronic rhinosinusitis : a case control study. / Schlosser, Rodney J.; Smith, Timothy L.; Mace, Jess C.; Alt, Jeremiah; Beswick, Daniel M.; Mattos, Jose L.; Payne, Spencer; Ramakrishnan, Vijay R.; Soler, Zachary M.

In: International Forum of Allergy and Rhinology, Vol. 10, No. 1, 01.01.2020, p. 7-14.

Research output: Contribution to journalArticle

Schlosser, RJ, Smith, TL, Mace, JC, Alt, J, Beswick, DM, Mattos, JL, Payne, S, Ramakrishnan, VR & Soler, ZM 2020, 'Factors driving olfactory loss in patients with chronic rhinosinusitis: a case control study', International Forum of Allergy and Rhinology, vol. 10, no. 1, pp. 7-14. https://doi.org/10.1002/alr.22445
Schlosser, Rodney J. ; Smith, Timothy L. ; Mace, Jess C. ; Alt, Jeremiah ; Beswick, Daniel M. ; Mattos, Jose L. ; Payne, Spencer ; Ramakrishnan, Vijay R. ; Soler, Zachary M. / Factors driving olfactory loss in patients with chronic rhinosinusitis : a case control study. In: International Forum of Allergy and Rhinology. 2020 ; Vol. 10, No. 1. pp. 7-14.
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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.

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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.

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