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. 2020 Nov 23;10(11):989.
doi: 10.3390/diagnostics10110989.

Radiological Markers of the Olfactory Cleft: Relations to Unilateral Orthonasal and Retronasal Olfactory Function

David T Liu  1 , Ursula Schwarz-Nemec  2 , Bertold Renner  3   4 , Christian A Mueller  1 , Gerold Besser  1
Affiliations

Radiological Markers of the Olfactory Cleft: Relations to Unilateral Orthonasal and Retronasal Olfactory Function

David T Liu et al. Diagnostics (Basel). .

Abstract

The opacification of the olfactory cleft (OC) has been associated with birhinal orthonasal olfaction in patients with chronic rhinosinusitis (CRS). The aim of this study was to determine the associations between monorhinal and birhinal orthonasal, and retronasal olfaction with radiological markers of the OC in a cohort of patients with CRS. Results were analyzed in a CRS-cohort including 13 patients with nasal polyposis (CRSwNP) and 12 patients with non-eosinophilic CRS (non-eCRS). Monorhinal and birhinal orthonasal olfactory function, and OC-air volume were higher in non-eCRS compared CRSwNP. OC-opacification was also higher in CRSwNP compared to non-eCRS. In the entire CRS-cohort, those with higher OC-opacification showed significantly lower orthonasal and retronasal olfactory test results compared to those with lower OC-opacification across all three coronal planes. Similarly, higher unilateral OC-opacification was also associated with lower ipsilateral orthonasal olfactory function. Correlation analysis further revealed a positive correlation between monorhinal and birhinal orthonasal olfaction with ipsilateral and overall OC-air volume. Likewise, birhinal and monorhinal orthonasal, and retronasal olfactory test results correlated negatively with the overall and ipsilateral Lund-Mackay scores. Monorhinal and birhinal orthonasal, and retronasal olfactory function were lower in CRS patients with higher ipsilateral and overall OC-opacification compared to those with lower OC-opacification.

Keywords: Lund-Mackay; anosmia; candy smell test; chronic rhinosinusitis; computed tomography; flavor; olfaction; olfactory cleft; retronasal; smell.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Caudal boundaries of the olfactory cleft (OC) used for OC-air volume analysis. The left side of the picture is the right side of the patient. (A) Horizontal line drawn 1 cm inferior to the cranial boundary. (B) Horizontal line drawn at the lower border of the superior turbinate; (C) horizontal line drawn at the head of the middle turbinate.
Figure 2
Figure 2
Two-dimensional cross-sectional analysis of the OC-cleft opacification in a patient with non-eosinophilic chronic rhinosinusitis. This patient had a TDI score of 29.5 at the right nostril, while olfactory testing of the left side revealed a TDI score of 22. The left side of the picture is the right side of the patient. (A) Anterior section, (B) middle section, and (C) posterior section.
Figure 3
Figure 3
Birhinal orthonasal and retronasal olfactory function in chronic rhinosinusitis (CRS) patients with partial or complete obstruction of the olfactory cleft (OC). OC-opacification were assessed based on an anterior, middle, and posterior two-dimensional coronal plane. TDI best = birhinal orthonasal olfactory function, CST = retronasal olfactory function. OC-opacification assessed in the anterior section (A,D), middle section (B,E), and posterior section (C,F). *p < 0.05, ***p < 0.01.
Figure 4
Figure 4
Monorhinal orthonasal olfactory function in CRS patients with partial or complete obstruction of the ipsilateral olfactory cleft (OC). Unilateral OC-opacification were assessed based on an anterior, middle, and posterior two-dimensional coronal plane. TDI left = orthonasal olfactory function of the left nostril, TDI right = orthonasal olfactory function of the right nostril. OC-opacification assessed in the ipsilateral anterior section (A,D), ipsilateral middle section (B,E), and ipsilateral posterior section (C,F). *p < 0.05, ***p < 0.01.
Figure 5
Figure 5
Correlation matrix between olfactory test results and olfactory cleft (OC)-air volume. The number represents Pearson’s r. Air volume 1 = the caudal boundary of the OC was defined at 1 cm inferior to the cranial boundary. Air volume 2 = the caudal boundary of the OC was defined at the lower border of the superior turbinate. Air volume 3 = the caudal boundary of the OC was defined at the head of the middle turbinate. TDI left = orthonasal olfactory function of the left nostril. TDI right = orthonasal olfactory function of the right nostril. TDI best = birhinal orthonasal olfactory function.
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