Longitudinal improvement and stability of olfactory function in the evaluation of surgical management for chronic rhinosinusitis.
Longitudinal improvement and stability of olfactory function in the evaluation of surgical management for chronic rhinosinusitis.
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DOI：
10.1002/alr.21800
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发表时间：
2016-11
影响因子：
6.4
通讯作者：
Smith, Timothy L.
中科院分区：
文献类型：
--
作者：
Levy, Joshua M.;Mace, Jess C.;Sansoni, E. Ritter;Soler, Zachary M.;Smith, Timothy L.
嗅觉异常是慢性鼻-鼻窦炎(CRS)的常见症状，并与各种鼻窦炎症状有关。简明嗅觉鉴定测试(BSIT)已经证明了内窥镜鼻窦手术(ESS)后异常嗅觉检测的改善，但该仪器对嗅觉的研究仍不够深入。辨别纵向的、术后嗅觉的耐受性对于患者咨询至关重要。对患有顽固性CRS的成年受试者进行前瞻性的多机构队列研究，并在ESS后观察18个月。使用在基线、术后6个月、12个月和18个月收集的BSIT评分进行嗅觉手术，并使用重复测量的方差分析进行比较。122名参与者符合纳入标准，是在2011年3月至2014年2月期间招募的。在6个月的随访中，所有参与者的平均BSIT评分都有改善(p=0.014)，其中鼻息肉患者的改善最大(p=0.001)。总体而言，6个月和18个月的平均BSIT评分没有差异，但合并哮喘(F(2)=5.29；p=0.010)和鼻息肉(F(2)=3.99；p=0.033)的患者报告的平均评分显著恶化。所有受试者的嗅觉异常发生率从术前的28%降至6个月时的17%(p=0.015)，术后12个月(19%；p=0.791)或18个月(21%；p=0.581)无显著变化。根据BSIT评分，ESS术后6个月嗅觉有改善，其中接受息肉切除术的患者改善最大。对于大多数患者亚组，ESS术后6个月至18个月的总体改善持续存在，然而，哮喘和鼻息肉患者的嗅觉障碍在最初改善后恶化，突显了进一步确定与CRS嗅觉异常相关的预后因素的必要性。
Abnormal olfaction is common with chronic rhinosinusitis (CRS) and associates with various measures of sinonasal inflammation. The Brief Smell Identification Test (BSIT) has demonstrated improvements in abnormal olfactory detection following endoscopic sinus surgery (ESS), but olfaction remains understudied using this instrument. Discerning longitudinal, postoperative durability in olfaction is critical for patient counseling. Adult participants with medically recalcitrant CRS were prospectively enrolled into a multi-institutional cohort study and observed for 18-months following ESS. Olfaction was operationalized using BSIT scores collected at baseline, 6-months, 12-months, and 18-months postoperatively and compared using repeated measures ANOVA. 122 participants met inclusion criteria and were recruited between March, 2011 and February, 2014. Improvement in mean BSIT scores at 6-month follow-up were reported for all participants (p=0.014) with greatest improvement in subjects with nasal polyposis (p=0.001). No differences in mean BSIT scores were found between 6-month and 18-months overall, however subjects with comorbid asthma (F(2)=5.29; p=0.010) and nasal polyposis (F(2)=3.99; p=0.033) reported significant mean worsening. Prevalence of abnormal olfaction decreased from 28% preoperatively to 17% at 6-months (p=0.015), for all subjects, without significant change 12-months (19%; p=0.791) or 18-months (21%; p=0.581) postoperatively. Postoperative improvement in olfaction was reported 6-months after ESS using BSIT scores, with greatest improvements in patients undergoing polypectomy. Overall improvement persisted between 6-month and 18-month following ESS for most patient subgroups, however, dysosmia worsened after initial improvement in patients with asthma and nasal polyps, highlighting the need for further identification of prognostic factors associated with abnormal olfaction in CRS.
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影响因子：
120.7
作者：
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通讯作者：
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