Olfactory Cleft Computed Tomography Analysis and Olfaction in Chronic Rhinosinusitis

Kohli, Preeti; Schlosser, Rodney J.; Storck, Kristina A.; Soler, Zachary M.

doi:10.2500/ajra.2016.30.4365

Cited by 31 publications

(45 citation statements)

References 19 publications

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“…A subset of patients did not undergo CT scan as a part of their clinical care. Cross‐sectional analysis of CT scans was performed using OsiriX MD imaging software (Pixmeo, Bernex, Switzerland), as reported elsewhere . This analysis required specific formatting with thin (0.6‐mm) cut axial, coronal, and sagittal planes for consistency, so some CT scans were excluded.…”

Section: Methodsmentioning

confidence: 99%

“…Cross-sectional analysis of CT scans was performed using OsiriX MD imaging software (Pixmeo, Bernex, Switzerland), as reported elsewhere. 18 This analysis required specific formatting with thin (0.6-mm) cut axial, coronal, and sagittal planes for consistency, so some CT scans were excluded. Anterior, middle, and posterior 2-dimensional cross-sectional areas were demarcated in the coronal plane using the axial and sagittal planes for reference of anatomic landmarks.…”

Section: Radiologic Evaluationmentioning

confidence: 99%

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Correlation of mucus inflammatory proteins and olfaction in chronic rhinosinusitis

Soler

Yoo

Schlosser

et al. 2019

Int Forum Allergy Rhinol

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Background Chronic rhinosinusitis (CRS) is one of the most common causes of olfactory loss, but the pathophysiology underlying olfactory dysfunction in CRS has not been fully elucidated. Previous studies found correlations between olfactory cleft (OC) inflammatory cytokines/chemokines and olfaction in CRS. The purpose of this study was to evaluate the relationship between OC mucus inflammatory proteins and olfaction in a multi‐institutional cohort. Methods Adults with CRS were prospectively recruited. Demographics, comorbidities, olfactory assessment (Sniffin’ Sticks), computed tomography (CT), and OC mucus for protein analysis were collected. Statistical analysis was performed to determine associations between olfactory function, OC mucus protein concentrations, and CT opacification. Results Sixty‐two patients were enrolled in the study, with an average age of 48.2 (standard deviation, 16.2) years, and 56.5% were female and 59.7% were classified as CRS with nasal polyps (CRSwNP). Ten of 26 OC mucus proteins were significantly correlated with threshold, discrimination, and identification (TDI) scores and OC opacification. Subgroup analysis by polyp status revealed that, within the CRSwNP group, C‐C motif ligand 2 (CCL2), interleukin‐5 (IL‐5), IL‐6, IL‐13, IL‐10, IL‐9, tumor necrosis factor‐α (TNF‐α), CCL5, and CCL11 were significantly correlated with olfaction. For CRS without nasal polyps (CRSsNP), only C‐X‐C ligand 5 (CXCL5) showed a correlation. In CRSwNP, IL‐6, IL‐10, vascular endothelial growth factor‐A, and immunoglobulin E (IgE) correlated with OC opacification, whereas, in CRSsNP, only CXCL5 showed a correlation. OC mucus proteins and Lund‐Mackay score correlated only in the CRSsNP group (CXCL5, IL‐5, IL‐13, IgE). Conclusion Several OC mucus proteins have been found to correlate with olfactory function and OC opacification. The profile of OC mucus proteins differs between CRSsNP and CRSwNP subgroups, suggesting different mechanisms between groups, but further study is required.

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Section: Methodsmentioning

confidence: 99%

Section: Radiologic Evaluationmentioning

confidence: 99%

Correlation of mucus inflammatory proteins and olfaction in chronic rhinosinusitis

Soler

Yoo

Schlosser

et al. 2019

Int Forum Allergy Rhinol

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“…Still, obstructive processes influence olfactory perception to a great extent in CRS, as reflected by studies on systematic scorings of edema, discharge, scarring, crusting, and polyps of the OC showing correlations with olfactory test results 19,20 . Also, quantifying the degree of opacification of the OC in CRS using computed tomography showed association with olfactory test results 21,22 . Furthermore, in CRS with nasal polyps, obstruction presumably leads to differences in orthonasal and retronasal olfactory function 23 .…”

Section: Discussionmentioning

confidence: 99%

Reversible obstruction of the olfactory cleft: impact on olfactory perception and nasal patency

Besser

Liu

Renner

et al. 2020

Int Forum Allergy Rhinol

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Background: Temporary disruption of sensory input can be studied relatively easily for vision or hearing by covering the eyes or ears. In contrast, closing the nostrils affects not only the sense of smell, but also the ability to breathe through the nose and humidify and warm inhaled air. We hypothesized that filling the olfactory cle (OC) with dissolvable nasal dressing (foam) would temporarily block olfaction while respecting nasal airflow. Methods:In 30 healthy volunteers, the OC was unilaterally obstructed in a back-to-front fashion. Orthonasal and retronasal olfactory function were tested before and after foam application. Ratings of odors and subjective nasal patency (SNP) were collected. Peak nasal inspiratory flow (PNIF) was used to measure nasal patency. Results:Foam was safely applied in every case using minimal instruments. No complications were reported. Orthonasal and retronasal test results decreased significantly in overall participants (all p < 0.0008). Indicating temporary anosmia, 3 subjects reached the lowest possible score for odor-threshold testing, with corresponding drops in retronasal test scores. PNIF values before and a er foam application were not significantly different (p = 0.11). SNP ratings decreased slightly, but not significantly (p = 0.052). Odor-intensity ratings dropped significantly (all p < 0.05). Conclusion:The OC can be safely obstructed with dissolvable nasal dressing, resulting in a decrease in odorintensity and orthonasal and retronasal olfactory function test scores. This procedure may serve as a hyposmia model that maintains normal nasal airflow.

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“…20 However, recent studies have challenged this approach. In their series of 107 patients, Adams et al 24 found no difference in cerebrospinal fluid leak recurrence rates between those with (19) and without (88) lumbar drains, irrespective of etiology. Repair technique and defect size (as opposed to body mass index) were the only reported predictors of recurrence.…”

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confidence: 94%

“…In a prospective clinical study of 62 patients, 46% experienced olfactory deterioration, with significant reduction in threshold, identification, and total smell scores (Connecticut Chemosensory Clinical Research Center olfactory test) up to 1 year after RAI. In addition, Kohli et al 19 examined the relationship between olfactory cleft opacification and olfaction in CRS patients with (12) and without (26) nasal polyposis. Volumetric analysis of the olfactory cleft using computed tomography imaging revealed significant correlations between the degree of opacification and olfactory threshold, discrimination, and identification scores (Sniffin' Sticks test), findings that were more pronounced in the CRS with nasal polyposis group.…”

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confidence: 99%

Paradigm shifts in the medical and surgical management of rhinologic and allergic disease

Lee¹

2016

am j rhinol allergy

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Olfactory Cleft Computed Tomography Analysis and Olfaction in Chronic Rhinosinusitis

Abstract: Background: Volumetric analysis of the olfactory cleft by using computed tomography has been associated with olfaction in patients with chronic rhinosinusitis (CRS)

Cited by 31 publications

References 19 publications

Correlation of mucus inflammatory proteins and olfaction in chronic rhinosinusitis

Correlation of mucus inflammatory proteins and olfaction in chronic rhinosinusitis

Reversible obstruction of the olfactory cleft: impact on olfactory perception and nasal patency

Paradigm shifts in the medical and surgical management of rhinologic and allergic disease

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