Abstract
Objectives: Patients with chronic rhinosinusitis usually present severe hyposmia/anosmia. The purpose of this study was to clarify the olfactory ability and the effect of endoscopic sinus surgery on patients with olfactory disturbance.
Methods: A retrospective analysis was performed on 92 patients with bronchial asthma who underwent endoscopic sinus surgery for rhinosinusitis. Olfactory abilities were measured with T&T olfactometer, the standard olfactory test kit in Japan. The olfactory clefts were observed by a rigid endoscope during the operations, and pieces of olfactory mucosa were obtained and examined for histological analysis. Steroids and/or puranlukast hydrate or montelukast sodium were administered for the patients on occasion.
Results: 54 cases of 92 patients (mean age, 52.5 years, 34 males and 20 females) presented olfactory disturbance pre-operatively. 47 of the 54 patients (87.0%) showed sever olfactory disturbance. 34 of the 54 cases had polyps in the olfactory clefts. 4 cases showed edematous appearance. 16 cases showed normal clefts. At 3 months after the endoscopic endonasal sinus surgery, the olfactory abilities of 41 cases (75.9%) were improved. However, the olfactory abilities of many patients fluctuated. We could obtain 12 pieces of olfactory mucosa. 9 of 12 specimens showed severe infiltration of eosinophils.
Conclusion: It was quite difficult to stabilize the olfactory ability of the patients with asthma. Numerous eosinophils infiltrated into the polypous olfactory mucosa. We consider that it is important to control the infiltration of eosinophils into the mucosa of olfactory cleft.