The Status of the Olfactory Cleft May Predict Postoperative Olfactory Function in Chronic Rhinosinusitis with Nasal Polyposis

Abstract

Preoperative CT findings, especially the anterior portion of the olfactory cleft, had a statistically significant association with the postoperative olfactory results in patients with CRS with nasal polyps.

Olfaction in Endoscopic Sinus and Skull Base Surgery

“…Of the 19 biopsy specimens that contained olfactory epithelium, 10 had an influx of lymphocytes, macrophages, and eosinophils. Seven of these 10 patients (70%) had an abnormal UPSIT score (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Of the 12 patients with a normosmia (UPSIT score >35), only 3 (25%) had an inflammatory response.…”

“…23,26 Kim and colleagues 26 graded the olfactory cleft opacification on CT scan as mild (0%-25%), moderate (25%-75%), and severe (>75%). Six months postoperatively the improvement in olfactory scores, on both the odor threshold and identification tests, was significantly better in the mild group than in the moderate or severe groups (P<.05).…”

“…A score of 5 or less suggests malingering. 25 Other odor identification tests include the Crosscultural Smell Identification Test (CCSIT; Sensonics, Haddon Heights, NJ), 26 Brief Smell Identification Test (Sensonics, Inc, Haddon Heights, NJ), 27 Smell Diskettes Olfaction Test (Novimed, Dietikon, Switzerland), 13,15 and Barcelona Smell Test (BAST-24; Barcelona, Spain). 28 Another olfaction measure used is the Sniffin' Sticks test (Burghart, Wedel, Germany), which uses a series of pens for threshold testing, discrimination testing, and identification testing.…”

Olfactory Cleft Computed Tomography Analysis and Olfaction in Chronic Rhinosinusitis

“…4,[11][12][13][14] Initial studies used semiquantitative olfactory cleft grading systems and/or only examined limited aspects of olfaction. Results of these studies indicated that opacification of the olfactory cleft was a better predictor of olfactory loss than opacification of the sinuses proper.…”

Chronic Rhinosinusitis and Olfactory Dysfunction

“…Litvack et al (2009a) have shown that the severity of quantitative olfactory disorder is associated with the importance of the sinonasal disease and that mean CT score is significantly higher in patients with hyposmia and anosmia than in normosmic patient. It was also demonstrated that the opacification of the olfactory cleft has a negative correlation with the olfactory function in patients with CRS and that it is significantly correlated with the postoperative olfactory results; patients with mild opacification having better postoperative results than patients with moderate and severe anterior olfactory cleft result (Kim et al, 2011). Fig.…”