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CC BY 4.0 · Int Arch Otorhinolaryngol 2024; 28(02): e234-e239
DOI: 10.1055/s-0043-1772494
Original Research

Olfaction and Quality of Life in Patients with Eosinophilic CRS Undergoing Endoscopic Sinus Surgery

Miguel Soares Tepedino 
1   Department of Otolaryngology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
2   Department of Otolaryngology, Policlinica de Botafogo, Rio de Janeiro, RJ, Brazil
3   Department of Otorhinolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Richard Louis Voegels
4   Department of Otolaryngology, University of São Paulo, São Paulo, SP, Brazil
,
Rogério Pezato
5   Department of Otolaryngology and Head & Neck Surgery, ENT Research Laboratory, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Andrew Thamboo
6   Division of Rhinology, University of British Columbia, Vancouver, Canada
,
Eduardo Macoto Kosug
3   Department of Otorhinolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Ana Clara Miotello Ferrão
7   Department of ENT, Policlinica de Botafogo, Rio de Janeiro, RJ, Brazil
,
Raíssa de Figueiredo Neves
7   Department of ENT, Policlinica de Botafogo, Rio de Janeiro, RJ, Brazil
,
Valéria Maria Barcia Castilla
7   Department of ENT, Policlinica de Botafogo, Rio de Janeiro, RJ, Brazil
,
Luis Carlos Gregório
3   Department of Otorhinolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
› Author Affiliations Funding The author(s) received no financial support for the research.
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Abstract

Introduction Chronic rhinosinusitis (CRS) is a common inflammatory disease. This high prevalence leads to high direct and indirect public health costs, which include medical visits, laboratory tests and imaging, pharmacotherapy, hospitalizations, and surgical treatment. Furthermore, CRS has a substantial impact on patient quality of life, affecting productivity and being a common cause of absence from work CRS-associated olfactory dysfunction is highly prevalent, the actual effectiveness of surgical intervention remains inconsistent. Although there are studies evaluating the postoperative course of patients with eosinophilic Chronic rhinosinusitis (eCRS) treated with high-volume budesonide irrigation, there is little objective information regarding the impact of this intervention on olfactory status and quality of life.

Objective To conduct a pre- and postoperative analysis of olfaction and quality of life in patients with eCRS treated with surgical intervention followed by high-volume budesonide nasal irrigation.

Methods Prospective, descriptive, uncontrolled study of patients with eCRS. All patients underwent pre- and postoperative nasal endoscopy, SNOT-22 questionnaire, and the University of Pennsylvania Smell Identification Text (UPSIT), always by the same previously trained examiner. The SNOT-22 questionnaire and the UPSIT were readministered to all patients at 3 months, 6 months, and 1 year postoperatively, and scores compared with those obtained preoperatively.

Results Twenty patients were included in the study, 13 males and 7 females, between the ages of 23 and 65; 8 patients had comorbid asthma. Quantitative evaluation using the UPSIT test showed a significant improvement in olfaction 3 months after surgery, which remained 6 months and 1 year after surgery (p = 0.0063).

There was no significant association between eosinophil concentrations in polypoid tissue and postoperative SNOT-22 and UPSIT results. Patients with tissue eosinophils >50 had a lower preoperative UPSIT score. As early as 3 months postoperatively, a significant improvement in quality of life was already noticeable, as represented by a decrease in SNOT-22 values, which persisted through the 1-year postoperative follow-up evaluation (p = 0.0005). Quantitative evaluation using the UPSIT test showed a significant improvement in olfaction 3 months after surgery, which remained 6 months and 1 year after surgery (p = 0.0063).

Conclusion Surgery effectively controlled eCRS in patients who adhered to high-volume budesonide nasal irrigation postoperatively. There were significant improvements in quality of life and olfaction, which persisted at least up to one year postoperatively.

Keywords

Chronic rhinosinusitis - olfaction - surgery - quality of life


Publication History

Received: 10 February 2023

Accepted: 18 June 2023

Article published online:
16 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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