[Assessment of olfactory disturbances in the patients with rhinosinusitis and polypi nasi treated by endoscopic sinus surgery]

Abstract

One of the most common symptoms of chronic rhinosinusitis with polyps is smell deterioration. Polypectomy and mechanical restoration of patency of the nose not always and not to the same degree leads to the sense of smell improvement. THE AIM OF STUDY was to assess the sense of smell and nasal patency in patients with chronic rhinosinusitis with polyps treated endoscopically during the healing period and the process of functional normalization of the nasal mucosa.

Material and methods: 30 patients suffering from chronic rhinosinusitis with polyps treated endoscopically were included in the study. Nasal resistance (anterior rhinomanometry), smell (smell threshold and identification tests) and rhinoscopic findings were assessed and analyzed 1, 3, 6 and 12 months postoperatively.

Results: The most conspicuous decrease of mean nasal resistance was observed in the first control examination (1 month postoperatively) and then further slight improvement continued until sixth postoperative month. Restoration of the patency of the nose yielded only inconsiderable improvement of smell in first postoperative month. Significant improvement of smell could be detected as late as in third and sixth month after the operation. In the twelfth postoperative month slight deterioration of the mean results of smell and nasal patency tests was noted. At the same time control endoscopic examination revealed recurrent polyposis in 26.6% of patients whereas the improvement in mean smell test result in comparison to preoperative results was observed in over 66.6% of patients.

Conclusions: The smell improvement in patients with rhinosinusitis with polyps after endoscopic surgery occurs later than the nasal patency improvement what may be attributed to the process of healing and functional normalization of the nasal mucosa. On average after a year in some patients first clinical symptoms of recurrent disease emerges. Taking in to the consideration chronic and complex nature of the disease it seems reasonable to assess nasal resistance and smell during longer follow up period.