Vasyl Bogdanov1,2,3, Ute Walliczek-Dworschak1,4, Katherine L Whitcroft1,5,6, Basile N Landis1,7, Thomas Hummel1. 1. Smell & Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden. 2. Klinik für Hals-Nasen-Ohrenkrankheiten, Kopf- und Halschirurgie, Carl-Thiem-Klinium Cottbus gGmbH, Cottbus, Germany. 3. Department of Otorhinolaryngology, CRI CTMU Crimean University Clinic of the Crimean State Medical University n.a. S.I. Georgievsky, Simferopol, Ukraine. 4. Klinik für Hals-Nasen und Ohrenheilkunde, Universitätsklinikum Gießen und Marburg, Standort, Marburg. 5. University College London (UCL) Ear Institute, London, United Kingdom. 6. Centre for the Study of the Senses, Institute of Philosophy, School of Advanced Study, University of London, London, United Kingdom. 7. Unité de Rhinologie-Olfactologie, Service d'Oto-Rhino-Laryngologie et de Chirurgie cervico-faciale, Hôpitaux Universitaires de Genève, Genève, Switzerland.
Abstract
OBJECTIVES: Olfaction is frequently impaired in chronic rhinosinusitis with nasal polyps (CRSwNP) and often improves after endoscopic sinus surgery (ESS). Data about dynamics of olfactory changes after ESS are lacking, and little information is available concerning whether preoperatively administered glucocorticosteroids predict postoperative olfaction. Therefore, the aim of this study was to examine dynamics of olfaction after ESS in relation to the effect of preoperative administration of glucocorticosteroids in CRSwNP. METHODS: This prospective study included 52 CRSwNP patients (30 men, 22 women, mean age 54 ± 14 years) divided into a control group (n = 31) subjected to ESS without preoperative steroids and a treatment group (n = 21) receiving orally administered glucocorticosteroids preoperatively. Self-ratings of olfaction and olfactory testing using the extended Sniffin' Sticks test battery (threshold, discrimination and identification [TDI] score) were performed. Olfaction was measured preoperatively; after termination of glucocorticosteroid treatment (only treatment group); and 2 weeks, 1 month, and 3 months postoperatively. RESULTS: After glucocorticosteroids, TDI score significantly improved in 57% of patients, and olfactory function remained unchanged in 43%. In addition, improvement in TDI score after steroids and 3 months postoperatively were significantly correlated (r = 0.66, P = 0.01). Patients whose olfaction did not improve after glucocorticosteroids did not benefit from surgery. Regarding postoperative olfactory dynamics, TDI score reached its maximum 1 month postoperatively and decreased again approximately 3 months after surgery. CONCLUSION: Glucocorticosteroids improved olfaction in CRSwNP comparable to surgery. In addition, changes in relation to steroids predicted olfactory outcome postoperatively. Regarding the olfactory dynamics, it could be demonstrated that olfactory function increased 1 month after surgery and decreased 3 months postoperatively. LEVEL OF EVIDENCE: 2 Laryngoscope, 130:1616-1621, 2020.
OBJECTIVES: Olfaction is frequently impaired in chronic rhinosinusitis with nasal polyps (CRSwNP) and often improves after endoscopic sinus surgery (ESS). Data about dynamics of olfactory changes after ESS are lacking, and little information is available concerning whether preoperatively administered glucocorticosteroids predict postoperative olfaction. Therefore, the aim of this study was to examine dynamics of olfaction after ESS in relation to the effect of preoperative administration of glucocorticosteroids in CRSwNP. METHODS: This prospective study included 52 CRSwNP patients (30 men, 22 women, mean age 54 ± 14 years) divided into a control group (n = 31) subjected to ESS without preoperative steroids and a treatment group (n = 21) receiving orally administered glucocorticosteroids preoperatively. Self-ratings of olfaction and olfactory testing using the extended Sniffin' Sticks test battery (threshold, discrimination and identification [TDI] score) were performed. Olfaction was measured preoperatively; after termination of glucocorticosteroid treatment (only treatment group); and 2 weeks, 1 month, and 3 months postoperatively. RESULTS: After glucocorticosteroids, TDI score significantly improved in 57% of patients, and olfactory function remained unchanged in 43%. In addition, improvement in TDI score after steroids and 3 months postoperatively were significantly correlated (r = 0.66, P = 0.01). Patients whose olfaction did not improve after glucocorticosteroids did not benefit from surgery. Regarding postoperative olfactory dynamics, TDI score reached its maximum 1 month postoperatively and decreased again approximately 3 months after surgery. CONCLUSION:Glucocorticosteroids improved olfaction in CRSwNP comparable to surgery. In addition, changes in relation to steroids predicted olfactory outcome postoperatively. Regarding the olfactory dynamics, it could be demonstrated that olfactory function increased 1 month after surgery and decreased 3 months postoperatively. LEVEL OF EVIDENCE: 2 Laryngoscope, 130:1616-1621, 2020.
Authors: Jerome R Lechien; Thomas Radulesco; Justin Michel; Sven Saussez; Christian Calvo-Henriquez; Carlos M Chiesa-Estomba; Stéphane Hans; Maria R Barillari; Giovanni Cammaroto; Géraldine Descamps; Julien Hsieh; Luigi Vaira; Giacomo De Riu; Leigh Sowerby; Isabelle Gengler Journal: Head Neck Pathol Date: 2020-08-20