Response to Glucocorticosteroids Predicts Olfactory Outcome After ESS in Chronic Rhinosinusitis

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Vasyl Bogdanov - , Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Carl Gustav Carus Dresden, Carl Thiem Clinics Cottbus, V.I. Vernadsky Crimean Federal University (Author)
  • Ute Walliczek-Dworschak - , TUD Dresden University of Technology, University of Marburg (Author)
  • Katherine L. Whitcroft - , TUD Dresden University of Technology, University College London, School of Advanced Study (Author)
  • Basile N. Landis - , TUD Dresden University of Technology, University of Geneva (Author)
  • Thomas Hummel - , Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Carl Gustav Carus Dresden (Author)

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.

Details

Original languageEnglish
Pages (from-to)1616-1621
Number of pages6
JournalLaryngoscope
Volume130
Issue number7
Publication statusPublished - 1 Jul 2020
Peer-reviewedYes

External IDs

PubMed 31373696
ORCID /0000-0001-9713-0183/work/152545971

Keywords

ASJC Scopus subject areas

Keywords

  • anosmia, chronic rhinosinusitis, glucocorticosteroids, nasal polyps, Olfaction