Evaluation of olfactory dysfunction to estimate the presence of eosinophilic chronic rhinosinusitis in patients with asthma

Takahashi, Koichiro; Sadamatsu, Hironori; Suzuki, Kumiko; Tashiro, Hiroki; Kimura, Shinya; Kuratomi, Yuichiro; Sueoka‐Aragane, Naoko

doi:10.1016/j.resinv.2020.08.004

Cited by 6 publications

(9 citation statements)

References 26 publications

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“…Previous studies have attempted to analyze the relationship between ECRS and asthma. 5,8,11,12,[27][28][29] 31 In our study, patients with ECRS demonstrated higher asthma rates than NECRS (6.1% vs. 2.0%, p = .031). We proved that asthma is an excellent preoperative predictor of ECRS in Asian populations.…”

Section: Asthma Prevalence In the Asian Population With Ecrssupporting

confidence: 43%

Clinical feature‐based diagnosis criteria of eosinophil and non‐eosinophil chronic rhinosinusitis in Taiwan

Ma,

Hsieh,

Huang

et al. 2023

Laryngoscope Investig Oto

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BackgroundThe prevalence of eosinophilic chronic rhinosinusitis (ECRS) has increased in Taiwan with a higher recurrence rate of nasal polyps after surgery. Therefore, we aimed to formulate the pre‐operative diagnostic criteria for patients with ECRS in Taiwan.MethodsThis case–control study included patients diagnosed with CRS with nasal polyps (CRSwNP) who underwent functional endoscopic sinus surgery (FESS) at a tertiary hospital in Taiwan. The patients were classified into ECRS and non‐eosinophilic CRS (NECRS) groups based on their histopathology. Demographic data, symptom severity scores, and computed tomography findings of the two groups were analyzed. We utilized receiver operating characteristic curve (ROC) analysis to evaluate parameters that could predict the diagnosis of ECRS.ResultsTotal 408 CRSwNP patients were enrolled (ECRS group: 163; NECRS group: 245). ECRS group was strongly associated with asthma (6.1% vs. 2.0%, p = .03), higher blood eosinophil counts (4.3% vs. 2.7%, p < .01), higher serum IgE (285.3 vs. 50.2 IU/mL, p = .02), and higher 22‐item Sino‐Nasal Outcome Test (SNOT‐22) score (40.5 vs. 36.7, p = .03). The ECRS criteria based on ROC curve included the SNOT‐22 (>45, 2 points), serum eosinophil count percentage (>4%, 4 points), asthma (4 points), total serum IgE (>140 IU/mL, 4 points), Lund–Mackay score (>9.5, 4 points), and ethmoid‐to‐maxillary opacification ratio on CT (>1.5, 5 points). The cutoff score was 14 points (sensitivity, 70.2%; specificity, 93.3%).ConclusionsClinical‐feature‐based criteria may predict the diagnosis of ECRS before FESS in Taiwan.Level of EvidenceLevel 3.

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Section: Asthma Prevalence In the Asian Population With Ecrssupporting

confidence: 43%

Clinical feature‐based diagnosis criteria of eosinophil and non‐eosinophil chronic rhinosinusitis in Taiwan

Ma,

Hsieh,

Huang

et al. 2023

Laryngoscope Investig Oto

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“…In cases of nasal decongestion testing, the use of VAS has been shown to be clinically relevant as it allows a fair degree of reliability in performing the test in the absence of rhinomanometry [15]. The VAS is a valuable tool in the field of rhinology, offering a reliable and accurate method for measuring and assessing nasal conditions and symptoms [16]. VAS is also helpful for measuring subjective experiences, such as OD.…”

Section: Discussionmentioning

confidence: 99%

Visual Analog Scale and Olfactory Objective Tests in Hyposmia Patients: Is There a Link?

Machado¹,

Sousa²,

Silva³

et al. 2023

Cureus

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IntroductionOlfactory dysfunction (OD) is often a devaluated sensorial affection. The objective evaluation of this dysfunction does not evaluate its compromise in patients' daily life. It is unclear to what extent there is a correlation between the objective evaluation of OD and patient-reported impairment. ObjectiveWe aim to search if Sniffin Sticks® correlates with the Visual Analog Scale (VAS) of Hyposmia Symptoms, and therefore if it is a useful method for clinical use. MethodsA prospective study was carried out to evaluate and compare consecutive patients who had olfactory impairment due to COVID-19 that were referred to an otolaryngology office. The variables evaluated were gender, age, co-morbidities, and olfactory thresholds (measured according to Sniffin Sticks®). Patients were also enquired about their sense of impairment according to VAS from 1 (worst possible) to 10 (best possible).Statistical analysis was performed using SPSS (IBM SPSS Statistics 26). Normal distribution was checked using both skewness and kurtosis and Kolmogorov-Smirnov tests. Pearson correlation test was used to seek a correlation between VAS and olfactory thresholds. All reported p-values are two-tailed, with a p-value ≤ 0.05 indicating statistical significance. ResultsOur sample of 47 patients was composed of 30 females (63.8%) and 17 females (36.2%). We found a mean variation between olfactory thresholds before and after the intervention of 3.91±2.466, and an average improvement of 2.29±2.93 in the visual analog scale for subjective evaluation of olfactory impairment. According to the Pearson correlation test, with 95% confidence, there is evidence to claim a moderate association (0.512) between an improvement in olfactory thresholds and VAS (p=0.05). ConclusionsThere was a moderate correlation between ratings and measures of olfactory function. On an individual basis, there were remarkable differences between measures and ratings of olfactory function. VAS should be considered in the evaluation of the hyposmic patient, due to its simplicity and quick applicability.

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“…Furthermore, patients with eosinophilic CRS showed significantly more eosinophils and fewer OMP‐positive cells than patients with noneosinophilic CRS 56 . It has been proposed that smell loss represented a clinical marker of severe CRS and was treated as a sensitive indicator of eosinophilic inflammation in patients with CRS 15,57–59 . A study by Hauser et al.…”

Section: Discussionmentioning

confidence: 99%

Olfactory cleft mucus eosinophil‐derived neurotoxin better reflects olfactory loss than blood eosinophil counts in patients with chronic rhinosinusitis

Wu,

Liu,

Bleier

et al. 2023

Int Forum Allergy Rhinol

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BackgroundEosinophils are associated with olfactory dysfunction in chronic rhinosinusitis (CRS) and eosinophil‐derived neurotoxin (EDN) is a sensitive marker of intense eosinophil activation. This study aimed to analyze olfactory cleft mucus and olfactory mucosa EDN levels and their association with olfactory dysfunction in CRS.MethodsWe prospectively recruited 150 patients with CRS electing endoscopic sinus surgery and 25 healthy controls. Both superior turbinate biopsy specimens and olfactory cleft mucus were collected to analyze EDN levels. Sniffin’ Sticks test scores, olfactory cleft computed tomography (CT) scores, and olfactory cleft endoscopy scale (OCES) were obtained. Multivariable logistic regression analysis was applied to analyze the predictability of EDN levels for olfactory dysfunction in CRS.ResultsChronic rhinosinusitis with olfactory dysfunction presented significantly higher olfactory mucosa (p = 0.016) and olfactory cleft mucus (p < 0.001) EDN levels than CRS without olfactory dysfunction. Mucus EDN levels were positively correlated with blood eosinophils (r = 0.625, p = 0.002), olfactory cleft CT scores (r = 0.738, p < 0.001), and OCES (r = 0.605, p = 0.004) in CRS. Furthermore, mucus EDN levels were significantly negatively correlated with threshold, discrimination, and identification (TDI) (r = ‐0.688), olfactory threshold (r = ‐0.606), olfactory discrimination (r = ‐0.608), and olfactory identification (r = ‐0.697) scores. After adjusting for patient demographics and comorbidities, mucus EDN levels were significantly associated with olfactory dysfunction in CRS (odds ratio = 2.162; p = 0.027). Mucus EDN levels showed a significantly better performance for predicting olfactory dysfunction than blood eosinophil counts (area under the curve, 0.873 vs. 0.764, p = 0.024).ConclusionOlfactory cleft mucus EDN level may be a better biomarker for predicting olfactory dysfunction in CRS than blood eosinophil counts.

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Evaluation of olfactory dysfunction to estimate the presence of eosinophilic chronic rhinosinusitis in patients with asthma

Cited by 6 publications

References 26 publications

Clinical feature‐based diagnosis criteria of eosinophil and non‐eosinophil chronic rhinosinusitis in Taiwan

Clinical feature‐based diagnosis criteria of eosinophil and non‐eosinophil chronic rhinosinusitis in Taiwan

Visual Analog Scale and Olfactory Objective Tests in Hyposmia Patients: Is There a Link?

Olfactory cleft mucus eosinophil‐derived neurotoxin better reflects olfactory loss than blood eosinophil counts in patients with chronic rhinosinusitis

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