Rodney J Schlosser1, Timothy L Smith2, Jess C Mace2, Jeremiah Alt3, Daniel M Beswick4, Jose L Mattos5, Spencer Payne5, Vijay R Ramakrishnan4, Zachary M Soler1. 1. Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC. 2. Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland, OR. 3. Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, UT. 4. Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Denver, CO. 5. Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, VA.
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.
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 CRSpatients compared to controls (mean ± standard deviation (SD) TDI = 22.4 ± 9.5 vs 28.8 ± 7.0, respectively, p < 0.001). Only 27% of CRSpatients 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 CRSpatients 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.
Authors: Jayant M Pinto; Kristen E Wroblewski; David W Kern; L Philip Schumm; Martha K McClintock Journal: J Gerontol A Biol Sci Med Sci Date: 2015-08-07 Impact factor: 6.053
Authors: Rodney J Schlosser; Jennifer K Mulligan; J Madison Hyer; Tom T Karnezis; David A Gudis; Zachary M Soler Journal: JAMA Otolaryngol Head Neck Surg Date: 2016-08-01 Impact factor: 6.223
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