Evaluation of Olfactory Dysfunction and Its Association with Nasal Endoscopic Findings in Chronic Rhinosinusitis Patients

Abstract

Background: Chronic Rhinosinusitis (CRS) is a common inflammatory disease of the nose and paranasal sinuses characterized by persistent symptoms lasting more than 12 weeks. Olfactory dysfunction is a frequently reported symptom among CRS patients and significantly affects quality of life. The severity of smell impairment may be associated with mucosal inflammation, nasal polyps, and structural abnormalities observed during nasal endoscopy.

Objectives

1. To assess olfactory function in patients with chronic rhinosinusitis.
2. To correlate olfactory dysfunction with nasal endoscopic and radiological findings.

Materials and Methods: A prospective observational study was conducted among 100 clinically diagnosed CRS patients attending the Department of Otorhinolaryngology of a tertiary care hospital over a period of 12 months. Olfactory function was assessed using the University of Pennsylvania Smell Identification Test (UPSIT). Nasal endoscopy was performed and scored according to the Lund-Kennedy system. Computed Tomography (CT) of the paranasal sinuses was evaluated using the Lund-Mackay scoring system. Statistical analysis was performed using Pearson correlation and Chi-square tests.

Results: Among 100 CRS patients, 62% demonstrated olfactory dysfunction. Hyposmia was observed in 45% and anosmia in 17% of patients. The prevalence of olfactory dysfunction was significantly higher in patients with nasal polyps (84.2%) compared to those without polyps (46.3%) (p<0.001). A significant positive correlation was observed between Lund-Kennedy endoscopic scores and severity of olfactory dysfunction (r=0.61, p<0.001). CT Lund-Mackay scores also showed a significant correlation with olfactory impairment (r=0.56, p<0.001).

Conclusion: Olfactory dysfunction is highly prevalent among CRS patients and is significantly associated with nasal endoscopic and radiological disease severity. Nasal endoscopy serves as a useful tool in predicting olfactory impairment and guiding clinical management.

Keywords: Chronic rhinosinusitis, Olfactory dysfunction, Hyposmia, Anosmia, Nasal endoscopy, Lund-Kennedy score.