Does olfactory function improve after endoscopic sinus surgery?

作者：Litvack Jamie R; Mace Jess; Smith Timothy L

来源：Otolaryngology - Head and Neck Surgery, 2009, 140(3): 312-319.

DOI：10.1016/j.otohns.2008.12.006

OBJECTIVE: To examine the impact of endoscopic sinus surgery (ESS) on olfactory impairment in patients with chronic rhinosinusitis (CRS) over intermediate and long-term follow-up. We hypothesized that patients with mild olfactory dyshyposmia) would benefit from ESS, whereas patients with severe olfactory dysanosmia) would not.
STUDY DESIGN: Prospective, multi-institutional cohort study.
SUBJECTS AND METHODS: A total of 111 patients presenting for ESS for treatment of CRS were examined preoperatively, and at 6 and 12 months postoperatively. Demographic, comorbidity, and Smell Identification Test (SIT) data were collected at each time point. Univariate and multivariate analyses were performed.
RESULTS: The prevalence of gender-adjusted olfactory dysfunction prior to surgery was 67.5 percent. Surprisingly, hyposmic patients did not significantly improve after Surgery. In contrast, patients with anosmia significantly improved after ESS (baseline, 6-mnonth SIT scores: 9.7 /- 2.0, 21.3 /- 11.2; P = 0.001). Improvement was sustained at 12-month follow-up (21.7 /- 10.7; P = 0.001). Multivariate linear regression analysis showed that baseline olfactory category and nasal polyposis were significantly associated with improvement in postoperative olfactory P = 0.035, P = 0.002).
CONCLUSION: Contrary to our hypotheses, patients with severe olfactory dysfunction significantly improved after ESS and sustained improvement over time, whereas patients with mild olfactory dysfunction did not.

• 出版日期2009-3