Zachary M Soler1, J Madison Hyer2, Tom T Karnezis1, Rodney J Schlosser1. 1. Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC. 2. Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC.
Abstract
BACKGROUND: Olfactory loss affects a majority of patients with chronic rhinosinusitis (CRS). Traditional objective measures of disease severity, including endoscopy scales, focus upon the paranasal sinuses and often have weak correlation to olfaction. METHODS: Adults with CRS were prospectively evaluated by blinded reviewers with a novel Olfactory Cleft Endoscopy Scale (OCES) that evaluated discharge, polyps, edema, crusting, and scarring of the olfactory cleft. Objective olfactory function was assessed using "Sniffin' Sticks" testing, including composite threshold-discrimination-identification (TDI) scores. Olfactory-specific quality of life was evaluated using the short modified version of the Questionnaire of Olfactory Disorders (QOD-NS). Interrater and intrarater reliability was assessed among 3 reviewers for OCES grading. Multivariate linear regression was then used to test associations between OCES scores and measures of olfaction, controlling for potential confounding factors. RESULTS: The OCES score was evaluated in 38 patients and had a high overall reliability (intraclass correlation coefficient [ICC] = 0.92; 95% confidence interval [CI], 0.91 to 0.96). The OCES significantly correlated with objective olfaction as measured by TDI score (p < 0.001), with TDI score falling by 1.13 points for every 1-point increase in OCES score. Similar significant associations were found for threshold, discrimination, and identification scores (p < 0.003 for all) after controlling for age, gender, race, and reviewer/review. The OCES was also highly associated with patient-reported QOD-NS scores (p = 0.009). CONCLUSION: A novel olfactory cleft endoscopy scale, OCES, shows high reliability and correlates with both objective and patient-reported olfaction in patients with CRS. Further studies to determine prognostic value and responsiveness to change are warranted.
BACKGROUND: Olfactory loss affects a majority of patients with chronic rhinosinusitis (CRS). Traditional objective measures of disease severity, including endoscopy scales, focus upon the paranasal sinuses and often have weak correlation to olfaction. METHODS: Adults with CRS were prospectively evaluated by blinded reviewers with a novel Olfactory Cleft Endoscopy Scale (OCES) that evaluated discharge, polyps, edema, crusting, and scarring of the olfactory cleft. Objective olfactory function was assessed using "Sniffin' Sticks" testing, including composite threshold-discrimination-identification (TDI) scores. Olfactory-specific quality of life was evaluated using the short modified version of the Questionnaire of Olfactory Disorders (QOD-NS). Interrater and intrarater reliability was assessed among 3 reviewers for OCES grading. Multivariate linear regression was then used to test associations between OCES scores and measures of olfaction, controlling for potential confounding factors. RESULTS: The OCES score was evaluated in 38 patients and had a high overall reliability (intraclass correlation coefficient [ICC] = 0.92; 95% confidence interval [CI], 0.91 to 0.96). The OCES significantly correlated with objective olfaction as measured by TDI score (p < 0.001), with TDI score falling by 1.13 points for every 1-point increase in OCES score. Similar significant associations were found for threshold, discrimination, and identification scores (p < 0.003 for all) after controlling for age, gender, race, and reviewer/review. The OCES was also highly associated with patient-reported QOD-NS scores (p = 0.009). CONCLUSION: A novel olfactory cleft endoscopy scale, OCES, shows high reliability and correlates with both objective and patient-reported olfaction in patients with CRS. Further studies to determine prognostic value and responsiveness to change are warranted.
Authors: Richard M Rosenfeld; Jay F Piccirillo; Sujana S Chandrasekhar; Itzhak Brook; Kaparaboyna Ashok Kumar; Maggie Kramper; Richard R Orlandi; James N Palmer; Zara M Patel; Anju Peters; Sandra A Walsh; Maureen D Corrigan Journal: Otolaryngol Head Neck Surg Date: 2015-04 Impact factor: 3.497
Authors: Zachary M Soler; John F Pallanch; Eugene Ritter Sansoni; Cameron S Jones; Lauren A Lawrence; Rodney J Schlosser; Jess C Mace; Timothy L Smith Journal: Int Forum Allergy Rhinol Date: 2015-05-26 Impact factor: 3.858
Authors: Frederick Yoo; Zachary M Soler; Jennifer K Mulligan; Kristina A Storck; Jensine M Lamira; Whitney N Pasquini; Jonathan B Hill; Tegan E Noonan; Brandon J Washington; Rodney J Schlosser Journal: Int Forum Allergy Rhinol Date: 2019-08-23 Impact factor: 3.858
Authors: Florence Othieno; Rodney J Schlosser; Kristina A Storck; Nicholas R Rowan; Timothy L Smith; Zachary M Soler Journal: Laryngoscope Date: 2018-04-10 Impact factor: 3.325
Authors: 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 Journal: Int Forum Allergy Rhinol Date: 2020-01 Impact factor: 3.858
Authors: Zachary M Soler; Rodney J Schlosser; Todd E Bodner; Jeremiah A Alt; Vijay R Ramakrishnan; Jose L Mattos; Jennifer K Mulligan; Jess C Mace; Timothy L Smith Journal: J Allergy Clin Immunol Date: 2021-02-04 Impact factor: 10.793
Authors: R J Schlosser; T L Smith; J C Mace; J A Alt; D M Beswick; J L Mattos; V Ramakrishnan; C Massey; Z M Soler Journal: Rhinology Date: 2021-04-01 Impact factor: 3.681
Authors: Zachary M Soler; Rodney J Schlosser; Jennifer K Mulligan; Timothy L Smith; Jess C Mace; Vijay R Ramakrishan; Kim Norris-Caneda; Jennifer R Bethard; Lauren E Ball Journal: Int Forum Allergy Rhinol Date: 2020-12-04 Impact factor: 5.426
Authors: Jose L Mattos; Zachary M Soler; Rodney J Schlosser; Jess C Mace; Jeremiah A Alt; Vijay R Ramakrishnan; Spencer C Payne; Timothy L Smith; Daniel M Beswick Journal: Am J Rhinol Allergy Date: 2020-09-20 Impact factor: 2.467
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