Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (3): 43-49.doi: 10.6040/j.issn.1673-3770.0.2022.041

Previous Articles     Next Articles

Research progress of olfactory dysfunction in chronic rhinosinusitis

WANG Huan1, HU Li1Overview,YU Hongmeng1,2   

  1. 1. Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital Affiliated to Fudan University, Shanghai 200031, China;
    2. Research Units of New Technologies of Endoscopic Surgery in Skull Base Tumor(2018RU003), Chinese Academy of Medical Sciences, Shanghai 200031, China
  • Published:2022-06-15

PDF (PC)

949

Abstract: Olfactory dysfunction, one of the main clinical symptoms in patients with chronic rhinosinusitis, seriously affects patients' quality of life. With improved socio-economic circumstances and social progress, demands for the improvement of olfactory function in patients with chronic rhinosinusitis have increased. Rhinologists, therefore, should be able to assess the severity of anosmia in chronic rhinosinusitis and choose appropriate and effective treatment methods. Accordingly, this article focuses on discussing the evaluation tools and treatment progress that has emerged in recent years to assist rhinologists with improving their diagnosis and treatment of this condition.

Key words: Chronic rhinosinusitis, Olfactory dysfunction, Endoscopic sinus surgery, Steroid, Biologic therapy

CLC Number: 

  • R765.4
[1] Shi JB, Fu QL, Zhang H, et al. Epidemiology of chronic rhinosinusitis: results from a cross-sectional survey in seven Chinese cities[J]. Allergy, 2015, 70(5): 533-539. doi:10.1111/all.12577.
[2] Hastan D, Fokkens WJ, Bachert C, et al. Chronic rhinosinusitis in Europe: an underestimated disease. A GA2LEN study[J]. Allergy, 2011, 66(9): 1216-1223. doi:10.1111/j.1398-9995.2011.02646.x.
[3] Fokkens WJ, Lund VJ, Hopkins C, et al. European position paper on rhinosinusitis and nasal polyps 2020[J]. Rhinology, 2020, 58(Suppl S29): 1-464. doi:10.4193/Rhin20.600.
[4] Kohli P, Naik AN, Harruff EE, et al. The prevalence of olfactory dysfunction in chronic rhinosinusitis[J]. Laryngoscope, 2017, 127(2): 309-320. doi:10.1002/lary.26316.
[5] Zhao K, Jiang JB, Pribitkin EA, et al. Conductive olfactory losses in chronic rhinosinusitis? A computational fluid dynamics study of 29 patients[J]. Int Forum Allergy Rhinol, 2014, 4(4): 298-308. doi:10.1002/alr.21272.
[6] Doty RL, Mishra A. Olfaction and its alteration by nasal obstruction, rhinitis, and rhinosinusitis[J]. Laryngoscope, 2001, 111(3): 409-423. doi:10.1097/00005537-200103000-00008.
[7] 陶丹丹, 董红军, 褚云锋, 等. 慢性鼻-鼻窦炎伴鼻息肉患者组织嗜酸性粒细胞与嗅觉功能障碍的相关性研究[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 16-20. doi:10.6040/j.issn.1673-3770.0.2019.388. TAO Dandan, DONG Hongjun, CHU Yunfeng, et al. Correlation between eosinophils and olfactory dysfunction in patients with CRSwNP after nasal operation[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6): 16-20. doi:10.6040/j.issn.1673-3770.0.2019.388.
[8] Wu J, Chandra RK, Li P, et al. Olfactory and middle meatal cytokine levels correlate with olfactory function in chronic rhinosinusitis[J]. Laryngoscope, 2018, 128(9): E304-E310. doi:10.1002/lary.27112.
[9] Wu D, Li Y, Bleier BS, Wei Y. Superior turbinate eosinophilia predicts olfactory decline in patients with chronic rhinosinusitis[J]. Ann Allergy Asthma Immunol, 2020, 125(3):304-310. doi: 10.1016/j.anai.2020.04.027.
[10] Yee KK, Pribitkin EA, Cowart BJ, et al. Analysis of the olfactory mucosa in chronic rhinosinusitis[J]. Ann N Y Acad Sci, 2009, 1170(1): 590-595. doi:10.1111/j.1749-6632.2009.04364.x.
[11] Yee KK, Pribitkin EA, Cowart BJ, et al. Neuropathology of the olfactory mucosa in chronic rhinosinusitis[J]. Am J Rhinol Allergy, 2010, 24(2): 110-120. doi:10.2500/ajra.2010.24.3435.
[12] Victores AJ, Chen MF, Smith A, et al. Olfactory loss in chronic rhinosinusitis is associated with neuronal activation of c-Jun N-terminal kinase[J]. Int Forum Allergy Rhinol, 2018, 8(3): 415-420. doi:10.1002/alr.22053.
[13] Kikuta S, Kuboki A, Yamasoba T. Protective effect of insulin in mouse nasal mucus against olfactory epithelium injury[J]. Front Neural Circuits, 2021, 15: 803769. doi:10.3389/fncir.2021.803769.
[14] Rouyar A, Classe M, Gorski R, et al. Type 2/Th2-driven inflammation impairs olfactory sensory neurogenesis in mouse chronic rhinosinusitis model[J]. Allergy, 2019, 74(3): 549-559. doi:10.1111/all.13559.
[15] Han PF, Whitcroft KL, Fischer J, et al. Olfactory brain gray matter volume reduction in patients with chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2017, 7(6): 551-556. doi:10.1002/alr.21922.
[16] Shehata EM, Tomoum MO, Amer MA, Alarabawy RA, Eltomey MA. Olfactory bulb neuroplasticity: a prospective cohort study in patients with chronic rhinosinusitis with nasal polyps[J]. Clin Otolaryngol, 2018, 43(6):1528-1534. doi: 10.1111/coa.13202.
[17] Güllmar D, Seeliger T, Gudziol H, et al. Improvement of olfactory function after sinus surgery correlates with white matter properties measured by diffusion tensor imaging[J]. Neuroscience, 2017, 360: 190-196. doi:10.1016/j.neuroscience.2017.07.070.
[18] Ren WW, Wang L, Zhang XJ, et al. Expansion of murine and human olfactory epithelium/mucosa colonies and generation of mature olfactory sensory neurons under chemically defined conditions[J]. Theranostics, 2021, 11(2): 684-699. doi:10.7150/thno.46750.
[19] Frasnelli J, Hummel T. Olfactory dysfunction and daily life[J]. Eur Arch Otorhinolaryngol, 2005, 262(3):231-235. doi: 10.1007/s00405-004-0796-y.
[20] Simopoulos E, Katotomichelakis M, Gouveris H, et al. Olfaction-associated quality of life in chronic rhinosinusitis: adaptation and validation of an olfaction-specific questionnaire[J]. Laryngoscope, 2012, 122(7): 1450-1454. doi:10.1002/lary.23349.
[21] Mattos JL, Bodner TE, Mace JC, et al. Psychometric properties of the brief version of the questionnaire of olfactory disorders in patients with chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2021, 11(10): 1436-1442. doi:10.1002/alr.22800.
[22] DeConde AS, Mace JC, Alt JA, et al. Longitudinal improvement and stability of the SNOT-22 survey in the evaluation of surgical management for chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2015, 5(3): 233-239. doi:10.1002/alr.21458.
[23] 金晓峰, 王剑, 李永金, 等. 简体中文版本嗅觉障碍生活质量量表的信度和效度分析[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(18): 1423-1429. doi:10.13201/j.issn.1001-1781.2016.18.001. JIN Xiaofeng, WANG Jian, LI Yongjin, et al. Reliability and validity analysis of simplified Chinese version of QOL questionnaire of olfactory disorders[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2016, 30(18): 1423-1429. doi:10.13201/j.issn.1001-1781.2016.18.001.
[24] Lötsch J, Reichmann H, Hummel T. Different odor tests contribute differently to the evaluation of olfactory loss[J]. Chem Senses, 2007, 33(1): 17-21. doi:10.1093/chemse/bjm058.
[25] Soler ZM, Hyer JM, Karnezis TT, et al. The Olfactory Cleft Endoscopy Scale correlates with olfactory metrics in patients with chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2016, 6(3): 293-298. doi:10.1002/alr.21655.
[26] Schlosser RJ, Smith TL, Mace JC, et al. The Olfactory Cleft Endoscopy Scale: a multi-institutional validation study in chronic rhinosinusitis[J]. Rhinology, 2021, 59(2): 181-190. doi:10.4193/Rhin20.307.
[27] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 嗅觉障碍诊断和治疗专家共识(2017年)[J]. 中华耳鼻咽喉头颈外科杂志, 2018,53(7): 484-494. doi:10.3760/cma.j.issn.1673-0860.2018.07.002.
[28] Loftus C, Schlosser RJ, Smith TL, et al. Olfactory cleft and sinus opacification differentially impact olfaction in chronic rhinosinusitis[J]. Laryngoscope, 2020, 130(10): 2311-2318. doi:10.1002/lary.28332.
[29] Kohli P, Schlosser RJ, Storck K, et al. Olfactory cleft computed tomography analysis and olfaction in chronic rhinosinusitis[J]. Am J Rhinol Allergy, 2016, 30(6): 402-406. doi:10.2500/ajra.2016.30.4365.
[30] Vandenhende-Szymanski C, Hochet B, Chevalier D, et al. Olfactory cleft opacity and CT score are predictive factors of smell recovery after surgery in nasal polyposis[J]. Rhin, 2015, 53(1): 29-34. doi:10.4193/rhin14.160.
[31] 苗旭涛, 刘佳, 魏永祥. 嗅觉传导通路的MRI评估[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(14): 1093-1096. doi:10.13201/j.issn.1001-1781.2014.14.028. MIAO Xutao, LIU Jia, WEI Yongxiang. MRI evaluation of the olfactory pathway[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2014, 28(14): 1093-1096. doi:10.13201/j.issn.1001-1781.2014.14.028.
[32] Sadeghi M, Amali A, Ezabadi SR, et al. Evaluation of the olfactory bulb volume and olfactory threshold in patients with nasal polyps and impact of functional endoscopic sinus surgery: a longitudinal study[J]. Int Forum Allergy Rhinol, 2015, 5(4): 356-360. doi:10.1002/alr.21478.
[33] Rombaux P, Potier H, Bertrand B, et al. Olfactory bulb volume in patients with sinonasal disease[J]. Am J Rhinol, 2008, 22(6): 598-601. doi:10.2500/ajr.2008.22.3237.
[34] Whitcroft KL, Fischer J, Han P, et al. Structural plasticity of the primary and secondary olfactory cortices: increased gray matter volume following surgical treatment for chronic rhinosinusitis[J]. Neuroscience, 2018, 395: 22-34. doi:10.1016/j.neuroscience.2018.10.011.
[35] Whitcroft KL, Noltus J, Andrews P, et al. Sinonasal surgery alters brain structure and function: Neuroanatomical correlates of olfactory dysfunction[J]. J Neurosci Res, 2021, 99(9): 2156-2171. doi:10.1002/jnr.24897.
[36] 张丽川, 胡春华, 韩星雨, 等. 鼻息肉患者组织嗜酸粒细胞计数与改良鼻窦CT嗅区评分及嗅觉功能的关系[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(12): 1142-1147. doi:10.13201/j.issn.1001-1781.2019.12.007. ZHANG Lichuan, HU Chunhua, HAN Xingyu, et al. Correlation of tissue eosinophil count and modified CT olfactory cleft score and olfactory function in patients with nasal polyps[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2019, 33(12): 1142-1147. doi:10.13201/j.issn.1001-1781.2019.12.007.
[37] 张丽川, 孙敬武, 李希平, 等. 内镜鼻窦手术对慢性鼻-鼻窦炎伴鼻息肉患者嗅觉功能转归的影响[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(8): 713-717. doi:10.13201/j.issn.1001-1781.2019.08.008. ZHANG Lichuan, SUN Jingwu, LI Xiping, et al. Effect of endoscopic sinus surgery on olfactory function in patients with chronic rhinosinusitis with nasal polyps[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2019, 33(8): 713-717. doi:10.13201/j.issn.1001-1781.2019.08.008.
[38] Banglawala SM, Oyer SL, Lohia S, et al. Olfactory outcomes in chronic rhinosinusitis with nasal polyposis after medical treatments: a systematic review and meta-analysis[J]. Int Forum Allergy Rhinol, 2014, 4(12): 986-994. doi:10.1002/alr.21373.
[39] Wu DW, Huang TH, Wei YX. Effects of fluticasone exhalation delivery system in patients with chronic rhinosinusitis with nasal polyps: a systematic review[J]. Am J Rhinol Allergy, 2022, 36(2): 176-184. doi:10.1177/19458924211033214.
[40] Kern RC, Stolovitzky JP, Silvers SL, et al. A phase 3 trial of mometasone furoate sinus implants for chronic sinusitis with recurrent nasal polyps[J]. Int Forum Allergy Rhinol, 2018, 8(4): 471-481. doi:10.1002/alr.22084.
[41] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会小儿学组、鼻科学组. 儿童鼻-鼻窦炎诊断和治疗建议(2012年, 昆明)[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(3): 177-179. doi:10.3760/cma.j.issn.1673-0860.2013.03.001.
[42] Lourijsen ES, Reitsma S, Vleming M, et al. Endoscopic sinus surgery with medical therapy versus medical therapy for chronic rhinosinusitis with nasal polyps: a multicentre, randomised, controlled trial[J]. Lancet Respir Med,2022,10(4):337-346. doi: 10.1016/S2213-2600(21)00457-4.
[43] DeConde AS, Mace JC, Alt JA, et al. Comparative effectiveness of medical and surgical therapy on olfaction in chronic rhinosinusitis: a prospective, multi-institutional study[J]. Int Forum Allergy Rhinol, 2014, 4(9): 725-733. doi:10.1002/alr.21350.
[44] Haxel BR. Recovery of olfaction after sinus surgery for chronic rhinosinusitis: a review[J]. Laryngoscope, 2019, 129(5): 1053-1059. doi:10.1002/lary.27764.
[45] Zhao R, Chen K, Tang Y. Olfactory changes after endoscopic sinus surgery for chronic rhinosinusitis: A meta-analysis[J].Clin Otolaryngol,2021,46(1):41-51. doi: 10.1111/coa.13639.
[46] Oka H, Tsuzuki K, Takebayashi H, et al. Olfactory changes after endoscopic sinus surgery in patients with chronic rhinosinusitis[J]. Auris Nasus Larynx, 2013, 40(5): 452-457. doi:10.1016/j.anl.2012.12.001.
[47] Minwegen F, Thomas JP, Bernal-Sprekelsen M, et al. Predictive value of disease severity on self-reported rating and quantitative measures of olfactory function outcomes after primary endoscopic sinus surgery. A prospective study[J]. Rhinology, 2014, 52(4): 437-443. doi:10.4193/Rhino14.043.
[48] Szaleniec J, Wróbel A, Strk P, et al. Smell impairment in chronic rhinosinusitis-evaluation of endoscopic sinus surgery results and review of literature concerning olfactory function predictors[J]. Otolaryngol Pol, 2015, 69(1): 33-44. doi:10.5604/00306657.1131143.
[49] Bogdanov V, Walliczek-Dworschak U, Whitcroft KL, et al. Response to glucocorticosteroids predicts olfactory outcome after ESS in chronic rhinosinusitis[J]. Laryngoscope, 2020, 130(7): 1616-1621. doi:10.1002/lary.28233.
[50] Zhang W, Meng YF, Wang CS, et al. Self-reported course of olfactory impairment determines outcome for successful surgical intervention in nasal polyps with anosmia[J]. Acta Otolaryngol, 2020, 140(12): 1021-1027. doi:10.1080/00016489.2020.1805508.
[51] 李华斌, 赖玉婷, 姜文秀. 慢性鼻窦炎的内表型研究进展及精准治疗[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 9-13. doi:10.6040/j.issn.1673-3770.1.2018.043. LI Huabin, LAI Yuting, JIANG Wenxiu. Endotypes and precision medicine in chronic sinusitis treatment[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(3): 9-13. doi:10.6040/j.issn.1673-3770.1.2018.043.
[52] Mullol J, Bachert C, Amin N, et al. Olfactory outcomes with dupilumab in chronic rhinosinusitis with nasal polyps[J]. J Allergy Clin Immunol Pract, 2022, 10(4): 1086-1095.e5. doi:10.1016/j.jaip.2021.09.037.
[53] Tsetsos N, Markou K, Konstantinidis I. Effect of monoclonal antibodies on olfactory dysfunction caused by chronic rhinosinusitis with nasal polyps: a systematic review and meta-analysis[J]. Int Forum Allergy Rhinol, 2020, 10(7): 893-900. doi:10.1002/alr.22576.
[54] Bachert C, Han JK, Wagenmann M, et al. EUFOREA expert board meeting on uncontrolled severe chronic rhinosinusitis with nasal polyps(CRSwNP)and biologics: definitions and management[J]. J Allergy Clin Immunol, 2021, 147(1): 29-36. doi:10.1016/j.jaci.2020.11.013.
[1] FENG Sicong, YU Xiaolan, LOU Dan. Evaluation of the effect of Messerklinger middle turbinate plasty on chronic rhinosinusitis with nasal polyps based on the expression of Ki67 and GM-CSF in vesicular tissue [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(3): 31-39.
[2] ZHAI Xuechun, BIAN Xin, CHEN Jingcai, DENG Jiayu, YE Zi, YANG Pingli. Characteristics and influencing factors of anxiety and depression in patients with chronic frontal sinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(2): 35-43.
[3] XIN Min, WANG Shaoming. Neuroimmune mechanisms and therapeutic strategies of inflammatory and infectious olfactory dysfunction [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(2): 111-124.
[4] LI Yangsong, YUAN Fayang, YANG Yan, ZHANG Tian, YU Guodong. Bibliometric analysis of biologic agents for the treatment of chronic rhinosinusitis based on the Web of Science database [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 54-64.
[5] XIONG Qin, ZHANG Yan, WU Rina, LI Feng, TANG Lixing. Application of intranasal corticosteroids in pediatrics [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 160-167.
[6] ZHANG Jiaqi, YUAN Ye, HONG Chen, GU Min, CHENG Lei, LU Meiping. Mendelian randomization study of gut microbiota, chronic sinusitis, and nasal polyps: Causal relationships and metabolite-mediated effects [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(5): 49-60.
[7] GUO Rongchang, LIU Qinghang, WANG Hongzeng, SUN Shujun. Through the orbit with sinus huge foreign bodies embedded in the base of the skull: a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 135-141.
[8] ZHANG Guangling, CHEN Xingxue, WU Tianyi, SUN Zhanwei, WANG Weiwei, LI Shichao,WANG Guangke. The expression and function of Tespa1 in chronic rhinosinusitis with nasal polyps [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(2): 35-42.
[9] CAO Zhengyong, LI Xiaobo. Comparison of the safety and efficacy of short-course postoperative topical glucocorticoid adjuvant therapy for eCRSwNP combined with asthma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(2): 43-50.
[10] WANG Aowei, SHI Wenjie. Study on correlation between traditional Chinese medicine syndrome types and TFH cell related factors in CRSwNP [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 54-60.
[11] ZHANG Jie, NIMA Jizong, XU Xiaodong, ZHOU Jing, LIU Jianmin, LUO Yirui, DU Jintao, BA Luo. Effect of Crocin on Type 2 inflammation in eosinophilic chronic rhinosinusitis with nasal polyps [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 61-67.
[12] HOU Jing, FANG Gaoli, ZHOU Bing. Formation mechanism and cyst fluid composition analysis of nasal mucosal cysts after functional endoscopy sinus surgery [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(5): 1-5.
[13] LI Ting, ZHAO Chong, WU Xian. The relationship between miR-34a expression in nasal mucosa tissue and postoperative recurrence in patients with chronic sinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(5): 20-25.
[14] CHEN Xingxue, ZHANG Guangling, WU Tianyi, WANG Weiwei, SUN Zhanwei, LI Shichao, WANG Guangke. Analysis of anti-IL-4Rα monoclonal antibody and endoscopic sinus surgery in the treatment of eosinophilic chronic rhinosinusitis with nasal polyps [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(4): 43-54.
[15] YUAN Yue, PANG Wenhui, CHEN Min, FU Shengyao, YU Longgang, SUN Yubo, LI Lingling. Clinical characteristics of mucormycotic rhinosinusitis in 25 cases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(4): 102-107.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd