Olfactory Outcomes after Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Meta-analysis. (December 2016)

• Record Type: Journal Article
• Authors: Kohli, Preeti; Naik, Akash N.; Farhood, Zachary; Ong, Adrian A.; Nguyen, Shaun A.; Soler, Zachary M.; Schlosser, Rodney J.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 155:Number 6(2016:Dec.)
• Page Start: 936
• Page End: 948
• Publication Date: 2016-12
• Subjects: olfaction -- smell -- sinus surgery -- chronic rhinosinusitis -- sinusitis -- meta-analysis; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599816664879
• Languages: English
• ISSNs: 0194-5998

Abstract

Objective: To use combined pre- and postsurgical olfactory outcomes to assess the impact of endoscopic sinus surgery on chronic rhinosinusitis−related olfactory impairment. Data Sources: CINAHL, Cochrane, OVID, EMBASE, PubMed, and SCOPUS. Each database was searched from inception up to October 2015. Review Methods: Studies were included that reported subjective or objective olfactory data in chronic rhinosinusitis patients before and after endoscopic sinus surgery. Results: Thirty-one studies were used in the meta-analysis. Weighted mean differences of olfactory measures demonstrated significant improvement in mixed CRS patients (those with and without polyps) through visual analog scales (−0.83, P = .001), altered taste/smell item on Sinonasal Outcome Test (−1.32, P < .00001), 40-item Smell Identification Test (3.49, P = .0010), and Sniffin' Sticks identification (0.34, P = .03). Chronic rhinosinusitis mixed patients demonstrated nonsignificant improvements via Sniffin' Sticks threshold (1.60, P = .16) and Brief Smell Identification Test (0.20, P = .32). When separated, polyp patients and dysosmic patients experienced the highest levels of olfactory improvement. Polyp patients improved by 7.87 ( P = .006) on the 40-item Smell Identification test, 11.54 ( P < .0001) with the Sniffin' Sticks total score, and 2.57 ( P < .00001) through Sniffin' Sticks identification. Dysosmic patients improved by 5.75 via the 40-item Smell Identification Test ( P = .0001). Conclusion: Endoscopic sinus surgery improves nearly all subjective and objective measures of olfaction in chronic rhinosinusitis patients. Patients with nasal polyposis or preoperative olfactory dysfunction improve to a greater degree.