ObjectivesTo investigate olfaction in general population, prevalence of olfactory dysfunction and related risk factors.DesignCross-sectional population-based survey, distributing four microencapsulated odorants (rose, banana, musk and gas) and two self-administered questionnaires (odour description; epidemiology/health status).SettingThe survey was distributed to general population through a bilingual (Catalan, Spanish) newspaper in Catalonia (Spain), on December 2003.ParticipantsNewspaper readers of all ages and gender; 9348 surveys were analysed from the 10 783 returned.Main outcome measuresCharacteristics of surveyed population, olfaction by age and gender, smell self-perception and smell impairment risk factors. Terms normosmia, hyposmia and anosmia were used when participants detected, recognised or identified all four, one to three or none of the odours, respectively.ResultsSurvey profile was a 43-year-old woman with medium–high educational level, living in a city. Olfaction was considered normal in 80.6% (detection), 56% (recognition/memory) and 50.7% (identification). Prevalence of smell dysfunction was 19.4% for detection (0.3% anosmia, 19.1% hyposmia), 43.5% for recognition (0.2% anosmia, 43.3% hyposmia) and 48.8% for identification (0.8% anosmia, 48% hyposmia). Olfaction was worse (p<0.0001) in men than in women through all ages. There was a significant age-related smell detection decline however smell recognition and identification increased up to fourth decade and declined after the sixth decade of life. Risk factors for anosmia were: male gender, loss of smell history and poor olfactory self-perception for detection; low educational level, poor self-perception and pregnancy for recognition; and older age, poor self-perception and history of head trauma and loss of smell for identification. Smoking and exposure to noxious substances were mild protective factors for smell recognition.ConclusionsSense of smell in women is better than in men suggesting a learning process during life with deterioration in older ages. Poor self-perception, history of smell loss, head trauma and pregnancy are potential risk factors for olfactory disorders.

A short course of oral steroids improved all nasal symptoms, polyp size, and nasal flow, whereas intranasal steroid maintain this effect.

The lower sensitivity of the inflamed nasal mucosa to glucocorticoids might be related to an increased expression of the glucocorticoid receptor (GR) beta isoform. We investigated GRalpha and GRbeta mRNA expression in epithelial cells from nasal mucosa and nasal polyps. GRalpha mRNA was at least 1000 times more expressed than GRbeta mRNA in both tissues. GRbeta expression (mean+/-SEM of 10(3) cDNA copies/microg of total RNA) was higher in nasal polyps (1.15+/-0.19; n=27; P<0.01) than in nasal mucosa (0.62+/-0.10; n=32). Nasal polyps with > 3% of inflammatory cells had higher GRbeta levels (1.40+/-0.29; n=16) than both nasal mucosa (P<0.01) and polyps with < or = 3% of inflammatory cells (0.80+/-0.18; n=11; P<0.05). No difference in GRbeta expression was found between nasal mucosa and polyps with < or = 3% of inflammatory cells. GRbeta expression correlated with the inflammatory cell number, especially with mast cells (r=0.50, P<0.0001). There was no difference in GRalpha mRNA expression between nasal mucosa and nasal polyps. In summary, GRalpha is far more expressed than GRbeta in both tissues. The increased expression of GRbeta may be related to the presence of inflammatory cells.

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OBJECTIVES: To prospectively evaluate the efficiency and safety of endoscopic sinus surgery (ESS) without nasal packing or other hemostatic agents. METHODS: Thirty patients who underwent ESS for chronic rhinosinusitis with or without polyps were prospectively enrolled. Nasal packing or hemostatic agents were not used in any of the patients at the conclusion of ESS. Patients with diabetes mellitus, hypertension, glaucoma, history of ocular surgery, or the use of anticoagulants were excluded. The blood loss during surgery, the postoperative sinonasal wound pain (by 0-10 visual analog scales, VAS), the surgical results, and the incidence of bleeding complications following surgery were reviewed. RESULTS: There were 11 women and 19 men with a mean age of 41.6. The mean estimated blood loss during surgery was 250 mL (range, 20-650 mL). The postoperative ophthalmic discomfort was caused by epiphora (2/30, 6.7%) and eye pressure (1/30, 3.3%). The mean VAS of pain was 0.77. There were no postoperative bleeding complications. The patient referral rate was 100% (30/30). CONCLUSIONS: Nasal packing or hemostatic agents were not necessary in endoscopic sinus surgeries in the selected patients. ESS, without the use of packing, is still a feasible and safe procedure.