Olfactory cleft and sinus opacification differentially impact olfaction in chronic rhinosinusitis
Objectives Prior studies have indicated that olfactory cleft (OC) opacification correlates with olfaction in patients with chronic rhinosinusitis (CRS). However, the results have been unclear in patients without polyps. The purpose of this study was to further explore the relationship between OC opa...
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| Veröffentlicht in: | The Laryngoscope 2020-10, Vol.130 (10), p.2311-2318 |
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| creator | Loftus, Catherine Schlosser, Rodney J. Smith, Timothy L. Alt, Jeremiah A. Ramakrishnan, Vijay R. Mattos, Jose L. Mappus, Elliott Storck, Kristina Yoo, Frederick Soler, Zachary M. |
| description | Objectives
Prior studies have indicated that olfactory cleft (OC) opacification correlates with olfaction in patients with chronic rhinosinusitis (CRS). However, the results have been unclear in patients without polyps. The purpose of this study was to further explore the relationship between OC opacification, sinus opacification, and olfactory function in patients with CRS.
Methods
One hundred and forty‐eight patients with CRS were prospectively enrolled across five institutions. Olfactory function was evaluated using the Sniffin’ Sticks tests (Burghardt, Wedel, Germany) and the 17‐item Questionnaire of Olfactory Disorders (QOD‐NS). Computed tomography (CT) scans for each patient were acquired and Lund‐Mackay scores recorded. Opacification of the OC was determined using OsiriX MD (Pixmeo, Bernex, Switzerland) and correlated with olfaction scores.
Results
A total of 148 CRS patients, 73 CRS without nasal polyps (CRSsNP) and 75 CRS with nasal polyps (CRSwNP), as well as 30 control subjects were enrolled. Overall OC opacification averaged 63.7% in CRS patients and 47.1% in control subjects (P |
| doi_str_mv | 10.1002/lary.28332 |
| format | Article |
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Prior studies have indicated that olfactory cleft (OC) opacification correlates with olfaction in patients with chronic rhinosinusitis (CRS). However, the results have been unclear in patients without polyps. The purpose of this study was to further explore the relationship between OC opacification, sinus opacification, and olfactory function in patients with CRS.
Methods
One hundred and forty‐eight patients with CRS were prospectively enrolled across five institutions. Olfactory function was evaluated using the Sniffin’ Sticks tests (Burghardt, Wedel, Germany) and the 17‐item Questionnaire of Olfactory Disorders (QOD‐NS). Computed tomography (CT) scans for each patient were acquired and Lund‐Mackay scores recorded. Opacification of the OC was determined using OsiriX MD (Pixmeo, Bernex, Switzerland) and correlated with olfaction scores.
Results
A total of 148 CRS patients, 73 CRS without nasal polyps (CRSsNP) and 75 CRS with nasal polyps (CRSwNP), as well as 30 control subjects were enrolled. Overall OC opacification averaged 63.7% in CRS patients and 47.1% in control subjects (P < 0.001). In the overall cohort, OC opacification significantly correlated with threshold, discrimination, and identification (TDI) (r = −0.520; P < 0.001) and QOD‐NS scores (r = 0.374; P < 0.001). CRSwNP patients demonstrated a significant correlation between OC opacification and TDI scores (r = −0.464; P < 0.001) but not the CRSsNP group (r = −0.143; P = 0.229). Lund‐Mackay score correlated with TDI in both the CRSsNP (r = −0.300; P = 0.010) and CRSwNP (r = −0.271; P = 0.019) groups.
Conclusion
CT opacification is associated with olfactory dysfunction differentially based on nasal polyp status. Smell loss in CRSwNP correlated with both OC opacification and Lund‐Mackay score, whereas CRSsNP correlated only with Lund‐Mackay score, indicating different relationships between olfactory function and local inflammatory processes in these disorders.
Level of Evidence
2 Laryngoscope, 130:2311–2318, 2020</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.28332</identifier><identifier>PMID: 31603563</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Chronic Disease ; chronic rhinosinusitis ; Computed tomography ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity - diagnostic imaging ; Nasal Polyps - complications ; Nasal Polyps - diagnostic imaging ; Olfaction disorders ; Olfaction Disorders - diagnostic imaging ; Olfaction Disorders - etiology ; olfactory disorders ; Polyps ; Prospective Studies ; Rhinitis ; Rhinitis - complications ; Sensory perception ; Sinuses ; Sinusitis ; Sinusitis - complications ; Smell ; Surveys and Questionnaires ; Tomography, X-Ray Computed ; United States</subject><ispartof>The Laryngoscope, 2020-10, Vol.130 (10), p.2311-2318</ispartof><rights>2019 The American Laryngological, Rhinological and Otological Society, Inc.</rights><rights>2020 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5142-4ab369013a8f313ad2748355a8afd9da5c6333b8d76b88e5debb996e1f6ab0813</citedby><cites>FETCH-LOGICAL-c5142-4ab369013a8f313ad2748355a8afd9da5c6333b8d76b88e5debb996e1f6ab0813</cites><orcidid>0000-0003-2748-0705 ; 0000-0003-2372-3431 ; 0000-0002-4304-595X ; 0000-0003-0560-5028 ; 0000-0002-6424-7083</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.28332$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.28332$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31603563$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Loftus, Catherine</creatorcontrib><creatorcontrib>Schlosser, Rodney J.</creatorcontrib><creatorcontrib>Smith, Timothy L.</creatorcontrib><creatorcontrib>Alt, Jeremiah A.</creatorcontrib><creatorcontrib>Ramakrishnan, Vijay R.</creatorcontrib><creatorcontrib>Mattos, Jose L.</creatorcontrib><creatorcontrib>Mappus, Elliott</creatorcontrib><creatorcontrib>Storck, Kristina</creatorcontrib><creatorcontrib>Yoo, Frederick</creatorcontrib><creatorcontrib>Soler, Zachary M.</creatorcontrib><title>Olfactory cleft and sinus opacification differentially impact olfaction in chronic rhinosinusitis</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>Objectives
Prior studies have indicated that olfactory cleft (OC) opacification correlates with olfaction in patients with chronic rhinosinusitis (CRS). However, the results have been unclear in patients without polyps. The purpose of this study was to further explore the relationship between OC opacification, sinus opacification, and olfactory function in patients with CRS.
Methods
One hundred and forty‐eight patients with CRS were prospectively enrolled across five institutions. Olfactory function was evaluated using the Sniffin’ Sticks tests (Burghardt, Wedel, Germany) and the 17‐item Questionnaire of Olfactory Disorders (QOD‐NS). Computed tomography (CT) scans for each patient were acquired and Lund‐Mackay scores recorded. Opacification of the OC was determined using OsiriX MD (Pixmeo, Bernex, Switzerland) and correlated with olfaction scores.
Results
A total of 148 CRS patients, 73 CRS without nasal polyps (CRSsNP) and 75 CRS with nasal polyps (CRSwNP), as well as 30 control subjects were enrolled. Overall OC opacification averaged 63.7% in CRS patients and 47.1% in control subjects (P < 0.001). In the overall cohort, OC opacification significantly correlated with threshold, discrimination, and identification (TDI) (r = −0.520; P < 0.001) and QOD‐NS scores (r = 0.374; P < 0.001). CRSwNP patients demonstrated a significant correlation between OC opacification and TDI scores (r = −0.464; P < 0.001) but not the CRSsNP group (r = −0.143; P = 0.229). Lund‐Mackay score correlated with TDI in both the CRSsNP (r = −0.300; P = 0.010) and CRSwNP (r = −0.271; P = 0.019) groups.
Conclusion
CT opacification is associated with olfactory dysfunction differentially based on nasal polyp status. Smell loss in CRSwNP correlated with both OC opacification and Lund‐Mackay score, whereas CRSsNP correlated only with Lund‐Mackay score, indicating different relationships between olfactory function and local inflammatory processes in these disorders.
Level of Evidence
2 Laryngoscope, 130:2311–2318, 2020</description><subject>Chronic Disease</subject><subject>chronic rhinosinusitis</subject><subject>Computed tomography</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nasal Cavity - diagnostic imaging</subject><subject>Nasal Polyps - complications</subject><subject>Nasal Polyps - diagnostic imaging</subject><subject>Olfaction disorders</subject><subject>Olfaction Disorders - diagnostic imaging</subject><subject>Olfaction Disorders - etiology</subject><subject>olfactory disorders</subject><subject>Polyps</subject><subject>Prospective Studies</subject><subject>Rhinitis</subject><subject>Rhinitis - complications</subject><subject>Sensory perception</subject><subject>Sinuses</subject><subject>Sinusitis</subject><subject>Sinusitis - complications</subject><subject>Smell</subject><subject>Surveys and Questionnaires</subject><subject>Tomography, X-Ray Computed</subject><subject>United States</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kV-LVCEYhyWKdtq66QOE0E0EZ1Pfo0dvgmXpHwwsREFdicejjYujk55TzLfPmdmW6qIbvfg9Pr76Q-gpJReUEPYqmrK_YBKA3UMryoF2vVL8Plq1EDrJ2Zcz9KjWG0LoAJw8RGdABQEuYIXMdfTGzrnssY3Oz9ikCdeQlorzztjggzVzyAlPwXtXXJqDiXGPw7alM87H04c8JGw3JadgcdmElI-OMIf6GD3wJlb35HY_R5_fvvl09b5bX7_7cHW57iynPet6M4JQhIKRHto6saGXwLmRxk9qMtwKABjlNIhRSscnN45KCUe9MCORFM7R65N3t4xbN9k2ajFR70rYtv_R2QT9d5LCRn_LP3S7p1cDb4IXt4KSvy-uznobqnUxmuTyUjUDwgkwGERDn_-D3uSlpPY8zfqeciUFVY16eaJsybUW5--GoUQfmtOH5vSxuQY_-3P8O_R3VQ2gJ-BniG7_H5VeX378epL-AiEmpps</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Loftus, Catherine</creator><creator>Schlosser, Rodney J.</creator><creator>Smith, Timothy L.</creator><creator>Alt, Jeremiah A.</creator><creator>Ramakrishnan, Vijay R.</creator><creator>Mattos, Jose L.</creator><creator>Mappus, Elliott</creator><creator>Storck, Kristina</creator><creator>Yoo, Frederick</creator><creator>Soler, Zachary M.</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2748-0705</orcidid><orcidid>https://orcid.org/0000-0003-2372-3431</orcidid><orcidid>https://orcid.org/0000-0002-4304-595X</orcidid><orcidid>https://orcid.org/0000-0003-0560-5028</orcidid><orcidid>https://orcid.org/0000-0002-6424-7083</orcidid></search><sort><creationdate>202010</creationdate><title>Olfactory cleft and sinus opacification differentially impact olfaction in chronic rhinosinusitis</title><author>Loftus, Catherine ; Schlosser, Rodney J. ; Smith, Timothy L. ; Alt, Jeremiah A. ; Ramakrishnan, Vijay R. ; Mattos, Jose L. ; Mappus, Elliott ; Storck, Kristina ; Yoo, Frederick ; Soler, Zachary M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5142-4ab369013a8f313ad2748355a8afd9da5c6333b8d76b88e5debb996e1f6ab0813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Chronic Disease</topic><topic>chronic rhinosinusitis</topic><topic>Computed tomography</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nasal Cavity - diagnostic imaging</topic><topic>Nasal Polyps - complications</topic><topic>Nasal Polyps - diagnostic imaging</topic><topic>Olfaction disorders</topic><topic>Olfaction Disorders - diagnostic imaging</topic><topic>Olfaction Disorders - etiology</topic><topic>olfactory disorders</topic><topic>Polyps</topic><topic>Prospective Studies</topic><topic>Rhinitis</topic><topic>Rhinitis - complications</topic><topic>Sensory perception</topic><topic>Sinuses</topic><topic>Sinusitis</topic><topic>Sinusitis - complications</topic><topic>Smell</topic><topic>Surveys and Questionnaires</topic><topic>Tomography, X-Ray Computed</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Loftus, Catherine</creatorcontrib><creatorcontrib>Schlosser, Rodney J.</creatorcontrib><creatorcontrib>Smith, Timothy L.</creatorcontrib><creatorcontrib>Alt, Jeremiah A.</creatorcontrib><creatorcontrib>Ramakrishnan, Vijay R.</creatorcontrib><creatorcontrib>Mattos, Jose L.</creatorcontrib><creatorcontrib>Mappus, Elliott</creatorcontrib><creatorcontrib>Storck, Kristina</creatorcontrib><creatorcontrib>Yoo, Frederick</creatorcontrib><creatorcontrib>Soler, Zachary M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Loftus, Catherine</au><au>Schlosser, Rodney J.</au><au>Smith, Timothy L.</au><au>Alt, Jeremiah A.</au><au>Ramakrishnan, Vijay R.</au><au>Mattos, Jose L.</au><au>Mappus, Elliott</au><au>Storck, Kristina</au><au>Yoo, Frederick</au><au>Soler, Zachary M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Olfactory cleft and sinus opacification differentially impact olfaction in chronic rhinosinusitis</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2020-10</date><risdate>2020</risdate><volume>130</volume><issue>10</issue><spage>2311</spage><epage>2318</epage><pages>2311-2318</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objectives
Prior studies have indicated that olfactory cleft (OC) opacification correlates with olfaction in patients with chronic rhinosinusitis (CRS). However, the results have been unclear in patients without polyps. The purpose of this study was to further explore the relationship between OC opacification, sinus opacification, and olfactory function in patients with CRS.
Methods
One hundred and forty‐eight patients with CRS were prospectively enrolled across five institutions. Olfactory function was evaluated using the Sniffin’ Sticks tests (Burghardt, Wedel, Germany) and the 17‐item Questionnaire of Olfactory Disorders (QOD‐NS). Computed tomography (CT) scans for each patient were acquired and Lund‐Mackay scores recorded. Opacification of the OC was determined using OsiriX MD (Pixmeo, Bernex, Switzerland) and correlated with olfaction scores.
Results
A total of 148 CRS patients, 73 CRS without nasal polyps (CRSsNP) and 75 CRS with nasal polyps (CRSwNP), as well as 30 control subjects were enrolled. Overall OC opacification averaged 63.7% in CRS patients and 47.1% in control subjects (P < 0.001). In the overall cohort, OC opacification significantly correlated with threshold, discrimination, and identification (TDI) (r = −0.520; P < 0.001) and QOD‐NS scores (r = 0.374; P < 0.001). CRSwNP patients demonstrated a significant correlation between OC opacification and TDI scores (r = −0.464; P < 0.001) but not the CRSsNP group (r = −0.143; P = 0.229). Lund‐Mackay score correlated with TDI in both the CRSsNP (r = −0.300; P = 0.010) and CRSwNP (r = −0.271; P = 0.019) groups.
Conclusion
CT opacification is associated with olfactory dysfunction differentially based on nasal polyp status. Smell loss in CRSwNP correlated with both OC opacification and Lund‐Mackay score, whereas CRSsNP correlated only with Lund‐Mackay score, indicating different relationships between olfactory function and local inflammatory processes in these disorders.
Level of Evidence
2 Laryngoscope, 130:2311–2318, 2020</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>31603563</pmid><doi>10.1002/lary.28332</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-2748-0705</orcidid><orcidid>https://orcid.org/0000-0003-2372-3431</orcidid><orcidid>https://orcid.org/0000-0002-4304-595X</orcidid><orcidid>https://orcid.org/0000-0003-0560-5028</orcidid><orcidid>https://orcid.org/0000-0002-6424-7083</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Chronic Disease chronic rhinosinusitis Computed tomography Female Humans Male Middle Aged Nasal Cavity - diagnostic imaging Nasal Polyps - complications Nasal Polyps - diagnostic imaging Olfaction disorders Olfaction Disorders - diagnostic imaging Olfaction Disorders - etiology olfactory disorders Polyps Prospective Studies Rhinitis Rhinitis - complications Sensory perception Sinuses Sinusitis Sinusitis - complications Smell Surveys and Questionnaires Tomography, X-Ray Computed United States |
| title | Olfactory cleft and sinus opacification differentially impact olfaction in chronic rhinosinusitis |
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