xRead - Olfactory Disorders (September 2023)

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PATEL et al.

TABLE VII.2 Section evidence summary: CRS related olfactory loss in relation to phenotype Study Year LOE Study design Study groups Clinical end point

Conclusions

Wu 179

Olfactory testing

OF and inflammatory mediators were largely dependent on polyp status Mucus protein levels (cytokines [IL-2, IL-5, IL-6, IL-10, and IL-13]) inversely correlated with OF by identification testing among the overall cohort IL-2, IL-5, IL-6, and IL-10 showed a negative correlation with OF among patients with CRSsNP; however, this was not statistically significant IL-5 and IL-13 were independent predictors of OF among all patients Elevated levels of IL-5 and IL-13 were seen among patients with CRSwNP compared with patients with CRSsNP 19 biopsy specimens had olfactory mucosa 9 patients had normal olfactory mucosa and normal OF (UPSIT R > 35) 10 patients had pathologic changes in olfactory mucosa, with 7 of these patients having olfactory deficits 3 patients had normal OF despite moderate chronic inflammation Correlations between mucus proteins and olfaction function persisted after stratifying for polyp status Olfactory loss in some patients with CRSwNP may result from direct inflammation of OC mucosa as opposed to alterations in nasal airflow from nasal polyposis CRSwNP was associated with higher mean tissue eosinophil counts (71.6 vs 28.1 eosinophils per high-power field, P < 0.05) and lower age-/sex-adjusted UPSIT R scores ( − 17.4vs − 6.2, P < 0.001) when compared with CRSsNP

2018 3b Case-control

CRS (n = 67) CRSwNP (53.7%) CRSsNP (46.3%) HCs (n = 12)

immediately before surgery (UPSIT R ) Olfactory mucus protein analysis

Kern 175

2009 3b Case-control

CRS (n = 26) HCs (n = 4)

Biopsy olfactory mucosa for histopathologic analysis Preoperative olfactory testing (UPSIT R )

Soler 183

Olfactory testing (SS-TDI) Olfactory mucus protein analysis Lund-Mackay CT score

2020 4

Cross-sectional

CRS (n = 62) CRSwNP (59.7%) CRSsNP (40.3%)

Hauser 178

2017 3b Case-control

CRS (n = 59) CRSwNP (54.2%) CRSsNP (45.8%) HCs (n = 10)

Olfactory testing

immediately before surgery (UPSIT R ) evaluation of ethmoid bulla (CRS) and ethmoid sinus or sphenoid face (controls)

Histopathological

(Continues)