Longitudinal improvement and stability of olfactory function in the evaluation of surgical management for chronic rhinosinusitis

Joshua M. Levy, Jess C. Mace, E. Ritter Sansoni, Zachary M. Soler, Timothy Smith

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Abnormal olfaction is common with chronic rhinosinusitis (CRS) and associates with various measures of sinonasal inflammation. The Brief Smell Identification Test (BSIT) has demonstrated improvements in abnormal olfactory detection following endoscopic sinus surgery (ESS), but olfaction remains understudied using this instrument. Discerning longitudinal, postoperative durability in olfaction is critical for patient counseling. Methods: Adult participants with medically recalcitrant CRS were prospectively enrolled into a multi-institutional cohort study and observed for 18 months after ESS. Olfaction was operationalized using BSIT scores collected at baseline, 6 months, 12 months, and 18 months postoperatively and compared using repeated measures analysis of variance (ANOVA). Results: A total of 122 participants met inclusion criteria and were recruited between March 2011 and February 2014. Improvement in mean BSIT scores at 6-month follow-up were reported for all participants (p = 0.014) with greatest improvement in subjects with nasal polyposis (p = 0.001). No differences in mean BSIT scores were found between 6 months and 18 months overall; however, subjects with comorbid asthma (F(2) = 5.29; p = 0.010) and nasal polyposis (F(2) = 3.99; p = 0.033) reported significant mean worsening. Prevalence of abnormal olfaction decreased from 28% preoperatively to 17% at 6 months (p = 0.015), for all subjects, without significant change at 12 months (19%; p = 0.791) or at 18 months (21%; p = 0.581) postoperatively. Conclusion: Postoperative improvement in olfaction was reported 6 months after ESS using BSIT scores, with greatest improvements in patients undergoing polypectomy. Overall improvement persisted between 6 months and 18 months after ESS for most patient subgroups; however, dysosmia worsened after initial improvement in patients with asthma and nasal polyps, highlighting the need for further identification of prognostic factors associated with abnormal olfaction in CRS.

Original languageEnglish (US)
JournalInternational Forum of Allergy and Rhinology
DOIs
StateAccepted/In press - 2016

Fingerprint

Smell
Nose
Olfaction Disorders
Counseling
Analysis of Variance
Cohort Studies
Asthma

Keywords

  • Chronic disease
  • Endoscopy
  • Longitudinal studies
  • Sinusitis
  • Smell

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Longitudinal improvement and stability of olfactory function in the evaluation of surgical management for chronic rhinosinusitis. / Levy, Joshua M.; Mace, Jess C.; Sansoni, E. Ritter; Soler, Zachary M.; Smith, Timothy.

In: International Forum of Allergy and Rhinology, 2016.

Research output: Contribution to journalArticle

@article{d35701214b034b7d81465ca18010d048,
title = "Longitudinal improvement and stability of olfactory function in the evaluation of surgical management for chronic rhinosinusitis",
abstract = "Background: Abnormal olfaction is common with chronic rhinosinusitis (CRS) and associates with various measures of sinonasal inflammation. The Brief Smell Identification Test (BSIT) has demonstrated improvements in abnormal olfactory detection following endoscopic sinus surgery (ESS), but olfaction remains understudied using this instrument. Discerning longitudinal, postoperative durability in olfaction is critical for patient counseling. Methods: Adult participants with medically recalcitrant CRS were prospectively enrolled into a multi-institutional cohort study and observed for 18 months after ESS. Olfaction was operationalized using BSIT scores collected at baseline, 6 months, 12 months, and 18 months postoperatively and compared using repeated measures analysis of variance (ANOVA). Results: A total of 122 participants met inclusion criteria and were recruited between March 2011 and February 2014. Improvement in mean BSIT scores at 6-month follow-up were reported for all participants (p = 0.014) with greatest improvement in subjects with nasal polyposis (p = 0.001). No differences in mean BSIT scores were found between 6 months and 18 months overall; however, subjects with comorbid asthma (F(2) = 5.29; p = 0.010) and nasal polyposis (F(2) = 3.99; p = 0.033) reported significant mean worsening. Prevalence of abnormal olfaction decreased from 28{\%} preoperatively to 17{\%} at 6 months (p = 0.015), for all subjects, without significant change at 12 months (19{\%}; p = 0.791) or at 18 months (21{\%}; p = 0.581) postoperatively. Conclusion: Postoperative improvement in olfaction was reported 6 months after ESS using BSIT scores, with greatest improvements in patients undergoing polypectomy. Overall improvement persisted between 6 months and 18 months after ESS for most patient subgroups; however, dysosmia worsened after initial improvement in patients with asthma and nasal polyps, highlighting the need for further identification of prognostic factors associated with abnormal olfaction in CRS.",
keywords = "Chronic disease, Endoscopy, Longitudinal studies, Sinusitis, Smell",
author = "Levy, {Joshua M.} and Mace, {Jess C.} and Sansoni, {E. Ritter} and Soler, {Zachary M.} and Timothy Smith",
year = "2016",
doi = "10.1002/alr.21800",
language = "English (US)",
journal = "International Forum of Allergy and Rhinology",
issn = "2042-6976",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Longitudinal improvement and stability of olfactory function in the evaluation of surgical management for chronic rhinosinusitis

AU - Levy, Joshua M.

AU - Mace, Jess C.

AU - Sansoni, E. Ritter

AU - Soler, Zachary M.

AU - Smith, Timothy

PY - 2016

Y1 - 2016

N2 - Background: Abnormal olfaction is common with chronic rhinosinusitis (CRS) and associates with various measures of sinonasal inflammation. The Brief Smell Identification Test (BSIT) has demonstrated improvements in abnormal olfactory detection following endoscopic sinus surgery (ESS), but olfaction remains understudied using this instrument. Discerning longitudinal, postoperative durability in olfaction is critical for patient counseling. Methods: Adult participants with medically recalcitrant CRS were prospectively enrolled into a multi-institutional cohort study and observed for 18 months after ESS. Olfaction was operationalized using BSIT scores collected at baseline, 6 months, 12 months, and 18 months postoperatively and compared using repeated measures analysis of variance (ANOVA). Results: A total of 122 participants met inclusion criteria and were recruited between March 2011 and February 2014. Improvement in mean BSIT scores at 6-month follow-up were reported for all participants (p = 0.014) with greatest improvement in subjects with nasal polyposis (p = 0.001). No differences in mean BSIT scores were found between 6 months and 18 months overall; however, subjects with comorbid asthma (F(2) = 5.29; p = 0.010) and nasal polyposis (F(2) = 3.99; p = 0.033) reported significant mean worsening. Prevalence of abnormal olfaction decreased from 28% preoperatively to 17% at 6 months (p = 0.015), for all subjects, without significant change at 12 months (19%; p = 0.791) or at 18 months (21%; p = 0.581) postoperatively. Conclusion: Postoperative improvement in olfaction was reported 6 months after ESS using BSIT scores, with greatest improvements in patients undergoing polypectomy. Overall improvement persisted between 6 months and 18 months after ESS for most patient subgroups; however, dysosmia worsened after initial improvement in patients with asthma and nasal polyps, highlighting the need for further identification of prognostic factors associated with abnormal olfaction in CRS.

AB - Background: Abnormal olfaction is common with chronic rhinosinusitis (CRS) and associates with various measures of sinonasal inflammation. The Brief Smell Identification Test (BSIT) has demonstrated improvements in abnormal olfactory detection following endoscopic sinus surgery (ESS), but olfaction remains understudied using this instrument. Discerning longitudinal, postoperative durability in olfaction is critical for patient counseling. Methods: Adult participants with medically recalcitrant CRS were prospectively enrolled into a multi-institutional cohort study and observed for 18 months after ESS. Olfaction was operationalized using BSIT scores collected at baseline, 6 months, 12 months, and 18 months postoperatively and compared using repeated measures analysis of variance (ANOVA). Results: A total of 122 participants met inclusion criteria and were recruited between March 2011 and February 2014. Improvement in mean BSIT scores at 6-month follow-up were reported for all participants (p = 0.014) with greatest improvement in subjects with nasal polyposis (p = 0.001). No differences in mean BSIT scores were found between 6 months and 18 months overall; however, subjects with comorbid asthma (F(2) = 5.29; p = 0.010) and nasal polyposis (F(2) = 3.99; p = 0.033) reported significant mean worsening. Prevalence of abnormal olfaction decreased from 28% preoperatively to 17% at 6 months (p = 0.015), for all subjects, without significant change at 12 months (19%; p = 0.791) or at 18 months (21%; p = 0.581) postoperatively. Conclusion: Postoperative improvement in olfaction was reported 6 months after ESS using BSIT scores, with greatest improvements in patients undergoing polypectomy. Overall improvement persisted between 6 months and 18 months after ESS for most patient subgroups; however, dysosmia worsened after initial improvement in patients with asthma and nasal polyps, highlighting the need for further identification of prognostic factors associated with abnormal olfaction in CRS.

KW - Chronic disease

KW - Endoscopy

KW - Longitudinal studies

KW - Sinusitis

KW - Smell

UR - http://www.scopus.com/inward/record.url?scp=84971373884&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84971373884&partnerID=8YFLogxK

U2 - 10.1002/alr.21800

DO - 10.1002/alr.21800

M3 - Article

C2 - 27218483

AN - SCOPUS:84971373884

JO - International Forum of Allergy and Rhinology

JF - International Forum of Allergy and Rhinology

SN - 2042-6976

ER -