Objective: To evaluate the influence of endoscopic sinus surgery on olfactory disorder caused by chronic sinusitis and nasal polyps, by testing the olfactory function of seventy-four patients before and after endoscopic sinus surgery,and evaluate the outcomes of olfactory dysfunction after endoscopic sinus surgery in patients with choinc rhinosinusitis and the related factors.
Method: The olfactory function of the seventy-four patients with chronic sinusitis and nasal polyps were tested by the T&T olfactory testing method at pre-operation and four weeks,twelve weeks, twenty-four weeks of post-operation. Patients were divided into two groups, according to whether combined with allergic rhinitis. Data were achieved by the scores of endoscopic appearances of Kennedy, and CT staging system of Lund-Mackey. Parallel processing standard endoscopic operation and processing specification during peri operation period. Analysing the degree of olfactory rehabilitation in chronic sinusitis and nasal polyps with allergic rhinitis.
Result: (1) Compared with the level of olfactory function, significant improvement was found at first month;however, the olfactory function level 4 weeks after operations was significantly statistically different with that 12 weeks and 24 weeks after operations; (2) Lund-Mackey sinus CT higher score is related to the worse degree of postoperative nasal olfactory rehabilitation (P < 0.05). (3) The higher scores of endoscopic appearances of Kennedy is related to the worse degree of postoperative nasal olfactory rehabilitation (P < 0.05). (4) Allergic rhinitis is one of the factors of olfactory rehabilitation in chronic rhinosinusitis with olfactory dysfunction olfactory rehabilitation, the olfactory rehabilitation of patients with allergic rhinitis is worse than that in the patients with no allergic rhinitis. (5) Course of disease is one of the factors of chronic rhinosinusitis with olfactory dysfunction olfactory rehabilitation. Longer the course of disease, worse the olfactory rehabilitation. (6) E osinophil count was related to olfactory rehabilitation in chronic rhinosinusitis with olfactory dysfunction olfactory rehabilitation. Higher Eosinophil count, worse the olfactory rehabilitation.
Conclusion: FESS plays a positive role in the improvement of olfactory impairment in patients with CRS. It is important to protect the olfactory mucous during surgical removal of sinonasal lesions. The standard intraoperative procedure, treatment on allergic rhinitis and regular follow-up after operation are also very important.