Andrew J Thomas1,2, Jess C Mace1, Vijay R Ramakrishnan3, Jeremiah A Alt4, Jose L Mattos5, Rodney J Schlosser6,7, Zachary M Soler6, Timothy L Smith1. 1. Division of Rhinology and Sinus/Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Oregon Health Center, Oregon Health & Science University, Portland, OR. 2. Department of Otorhinolaryngology, Ochsner Clinic Foundation, New Orleans, LA. 3. Department of Otolaryngology, University of Colorado, Aurora, CO. 4. Division of Otolaryngology-Head and Neck Surgery, Sinus and Skull Base Surgery Program, Department of Surgery, University of Utah, Salt Lake City, UT. 5. Division of Rhinology and Endoscopic Sinus Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, VA. 6. Division of Rhinology and Sinus/Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC. 7. Department of Surgery, Ralph H. Johnson Veteran Affairs Medical Center, Charleston, SC.
Abstract
BACKGROUND: Patients with chronic rhinosinusitis (CRS) commonly experience both reduced quality of life (QOL) and olfactory dysfunction (OD). Literature on the impacts of appropriate medical therapy (AMT) for CRS on QOL and OD is limited, and the focused design of these studies may limit their applicability to usual clinical practice. METHODS: Adults with symptomatic CRS were prospectively enrolled (November 2016 to October 2018) into an observational, multi-institutional study. Individualized AMT was initiated using standard practice according to evidence-based guidelines. Endoscopy examination (Lund-Kennedy), olfactory function (Sniffin' Sticks) testing, and QOL survey responses (22-item Sino-Nasal Outcome Test [SNOT-22], Questionnaire of Olfactory Disorders-Negative Statements [QOD-NS]) were obtained at enrollment and follow-up. RESULTS: Baseline measures demonstrated heterogeneity of QOL and OD. After an average of 7.8 weeks, within-subject median SNOT-22 total improved by 39.5% (n = 39, p < 0.001) relative to baseline, including 50% (p = 0.014) improvement for item #21, "Sense of smell/taste." QOD-NS improvement was also statistically significant (p = 0.044). Sniffin' Sticks score relative improvement of 10.9% (n = 33, p = 0.109) was not statistically significant and lacked correlation with SNOT-22 total scores (R = -0.247, p = 0.165) or QOD-NS total scores (R = -0.016, p = 0.930), but correlated moderately with endoscopy score (R = -0.436, p = 0.018). CONCLUSIONS: Participants with varied impacts of CRS, treated with individualized short-term AMT, demonstrated significant improvements in CRS- and olfactory-specific QOL measures, without corresponding improvement in clinically measured olfactory function. Olfactory function changes moderately correlated with endoscopy score changes, but lacked an association with QOL measurements.
BACKGROUND:Patients with chronic rhinosinusitis (CRS) commonly experience both reduced quality of life (QOL) and olfactory dysfunction (OD). Literature on the impacts of appropriate medical therapy (AMT) for CRS on QOL and OD is limited, and the focused design of these studies may limit their applicability to usual clinical practice. METHODS: Adults with symptomatic CRS were prospectively enrolled (November 2016 to October 2018) into an observational, multi-institutional study. Individualized AMT was initiated using standard practice according to evidence-based guidelines. Endoscopy examination (Lund-Kennedy), olfactory function (Sniffin' Sticks) testing, and QOL survey responses (22-item Sino-Nasal Outcome Test [SNOT-22], Questionnaire of Olfactory Disorders-Negative Statements [QOD-NS]) were obtained at enrollment and follow-up. RESULTS: Baseline measures demonstrated heterogeneity of QOL and OD. After an average of 7.8 weeks, within-subject median SNOT-22 total improved by 39.5% (n = 39, p < 0.001) relative to baseline, including 50% (p = 0.014) improvement for item #21, "Sense of smell/taste." QOD-NS improvement was also statistically significant (p = 0.044). Sniffin' Sticks score relative improvement of 10.9% (n = 33, p = 0.109) was not statistically significant and lacked correlation with SNOT-22 total scores (R = -0.247, p = 0.165) or QOD-NS total scores (R = -0.016, p = 0.930), but correlated moderately with endoscopy score (R = -0.436, p = 0.018). CONCLUSIONS:Participants with varied impacts of CRS, treated with individualized short-term AMT, demonstrated significant improvements in CRS- and olfactory-specific QOL measures, without corresponding improvement in clinically measured olfactory function. Olfactory function changes moderately correlated with endoscopy score changes, but lacked an association with QOL measurements.
Authors: Sarfaraz M Banglawala; Samuel L Oyer; Shivangi Lohia; Alkis J Psaltis; Zachary M Soler; Rodney J Schlosser Journal: Int Forum Allergy Rhinol Date: 2014-11-14 Impact factor: 3.858
Authors: Adam S DeConde; Jess C Mace; Jeremiah A Alt; Rodney J Schlosser; Timothy L Smith; Zachary M Soler Journal: Int Forum Allergy Rhinol Date: 2014-07-12 Impact factor: 3.858
Authors: A P Campbell; L P Hoehle; K M Phillips; D S Caradonna; S T Gray; A R Sedaghat Journal: Eur Ann Otorhinolaryngol Head Neck Dis Date: 2018-05-01 Impact factor: 2.080
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