A study on olfactory improvement assessed with butanol threshold test in chronic rhinosinusitis patients after fess at a tertiary care centre in Malabar region
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20232222Keywords:
Chronic rhinosinusitis, Olfactory dysfunction, Functional endoscopic sinus surgery, Butanol threshold testAbstract
Background: Chronic Rhinsinusitis is a hetreogenous disorder with a broad range of etiologic factors involving mucosa of nasal cavity and paranasal sinuses. Olfactory dysfunction has been reported in approximately 60-80% of patients who suffer from CRS.
Methods: Hospital based prospective observational study in the department of ENT, KMCT medical college, Mukkam done in Patients diagnosed with CRS who require FESS having anosmia or hyposmia as an additional symptom. Calculated sample size was 87. Butanol threshold test was done in patients before undergoing FESS and at 1st week,6th week and 24 weeks following FESS and improvement noted. Independent sample t test and ANOVA were used to test statistical significance
Results: Out of 87 subjects, 36% belonged to age group of 36-45 years 15-25 years was the least involved group and majority of patients had nasal obstruction (83.9%) or nasal discharge (81.6%). 69% of patients experienced facial pain and 79.3% had post nasal discharge. Pre operative BTT showed a mean value of 4.89.BTT at 1st week post op showed a mean value of 3.63. At 6 weeks post op BTT value showed significant difference from pre op value with a mean of 2.05 and at 24 weeks post op the mean BTT was 1.70
Conclusions: Summarising the results from our study we affirm that FESS improves olfactory function substantially in CRS patients especially in patients with polyps.
References
Watkinson JC, Clarke RW, Donne AJ. Scott Browns Otorhinolaryngology, head and neck surgery, 8th ed. USA: CRC Press; 2018:1025-34.
Ferguson BJ. Definitions of fungal rhinosinusitis. Otolaryngol Clin North Am. 2000;33(2):227-35.
Clarke RW, Donne AJ. Otorhinolaryngology, head and neck surgery. 8th ed. USA: CRC Press; 2018: 94.
Psaltis AJ, Li G, Vaezeafshar R, Cho KS, Hwang PH. Modification of the Lund-Kennedy endoscopic scoring system improves its reliability and correlation with patient-reported outcome measures. Laryngoscope. 2014;124(10):2216-23.
Hedman J, Kaprio J, Poussa T, Nieminen MM. Prevalence of asthma,aspirinintolerance,nasal polyposis and chronic obstructive pulmonary disease in a population-based study. Int J Epidemiol. 1999; 28(4):717-22.
Picado C. Aspirin intolerance and nasal polyposis. Curr Allergy Asthma Rep. 2002;2:488-93.
Watkinson JC, Clarke RW, Donne AJ. Scott Browns Otorhinolaryngology, head and neck surgery, 8th ed. USA: CRC Press; 2018:1048.
Dietz de Loos D, Lourijsen ES, Wildeman MAM, Freling NJM, Wolvers MDJ, Reitsma S, et al. Prevalence of chronic rhinosinusitis in the general population based on sinus radiology and symptomatology. J Allergy Clin Immunol. 2019; 143(3):1207-14.
Khan J, Abdul AU, Farzana PY. Regional prevalence of different types of sinusitis at a tertiary care centre in Northern India. IJOHNS. 2020;9:32.
Gudis DA, Soler ZM. Chronic Rhinosinusitis-Related Smell Loss: medical and surgical treatment efficacy. Curr Otorhinolaryngol Rep. 2016;4(2):142-7.
Saedi B, Sadeghi M, Yazdani N, Afshari A. Effectiveness of FESS in Smell Improvement of Sinusitis Patients. Indian J Otolaryngol Head Neck Surg. 2013;65(2):283-7.
Hirsch AG, Nordberg C, Bandeen-Roche K, Tan BK, Schleimer RP, Kern RC, et al. Radiologic sinus inflammation and symptoms of chronic rhinosinusitis in a population-based sample. Allergy. 2020;75(4): 911-20.
Catalano P, Ericksen M. Comparison of quality of life and Lund Mackay score in subgroups of rhinosinusitis. J Otolaryng Head Neck Surg. 2015;1:3.
Hopkins C, Browne JP, Slack R, Lund V, Brown P. The Lund-Mackay staging system for chronic rhinosinusitis: How is it used and what does it predict? Otolaryngol Head Neck Surg. 2007;137(4):555-61.
Litvack JR, Mace J, Smith TL. Does olfactory function improve after endoscopic sinus surgery?.Otolaryngol Head Neck Surg. 2009;140(3):312-9.
Haxel BR. Recovery of olfaction after sinus surgery for chronic rhinosinusitis: A review. Laryngoscope. 2019; 129(5):1053-9.
Rudmik L, Smith TL. Olfactory improvement after endoscopic sinus surgery. Curr Opin Otolaryngol Head Neck Surg. 2012;20(1):29-32.
Perry BF, Kountakis SE. Subjective improvement of olfactory function after endoscopic sinus surgery for chronic rhinosinusitis. Am J Otolaryngol. 2003; 24(6):366-9.
