2016 Volume 55 Issue 4 Pages 549-555
Objectives: Chronic rhinosinusitis (CRS) is one of the diseases that is most frequently associated with olfactory disorders. Conversely, few patients with allergic rhinitis (AR) complain of olfactory disorders. This study aimed to compare the olfactory disorders that occur in patients with AR and CRS.
Methods: Two hundred and thirty-nine patients with AR or CRS, who underwent primary bilateral inferior turbinate surgery (ITS) or endoscopic sinus surgery (ESS) whose olfactory acuity was evaluated at our department between March 2012 and April 2015, were enrolled. The patients aged from 20 to 49 y.o. were classified into three groups: i) 35 AR patients who underwent bilateral ITS (group ITS), ii) 35 CRS patients without eosinophilia (Eo≤5%) who underwent ESS (group ESS without Eo); and iii) 36 CRS patients with eosinophilia (Eo>5%) who underwent ESS (group ESS with Eo). The patients’ chief complaints, olfactory visual analog scale (VAS) scores, the severity of their olfactory disorders according to their mean recognition thresholds which were assessed with a T&T olfactometer, and their reactions to intravenously injected prosultiamine at the preoperative stage were retrospectively analyzed in both groups.
Results: None of the patients in the group ITS complained of olfactory disorders, whereas 37% (26/71) of the patients in the two ESS groups complained of them. The mean olfactory VAS score of the group ITS (71%) was significantly better than that of the two ESS groups (≈45%) (p<0.01). In the group ITS, the severity of the patients’ olfactory disorders (according to their mean recognition thresholds) was classified as normosmia in 16 (45%) patients, mild disorder in 15 (43%) patients, moderate disorder in 2 (6%) patients, severe hyposmia in 1 (3%) patients, and anosmia in 1 (3%) patients. The mean T&T recognition threshold (1.5 ± 1.2) of the group ITS was significantly milder than that of group ESS without Eo (3.4 ± 1.9) and group ESS with Eo (3.8 ± 2.0) (p<0.001). No significant correlation was detected between the VAS score and the mean recognition threshold in group ITS (rs = −0.322), whereas these differences in both two ESS groups were significant (p<0.001). As for the intravenous olfaction test, all (29/29) of the patients in the group ITS responded to prosultiamine, whereas 4.6% (3/65) of the two ESS groups did not respond.
Conclusion: This study demonstrated that patients with AR suffer from olfactory dysfunction, even if they do not complain of olfactory disorders. Although the frequency and severity of the olfactory disorders seen in patients with AR are lower and milder, respectively, than those seen in patients with CRS, it is important to accurately evaluate olfactory disorder in patients with AR.