Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-17T19:34:37.409Z Has data issue: false hasContentIssue false
  • English
  • Français

Reversibility of mucociliary clearance and olfaction impairment following endoscopic sinus surgery: a prospective observational study

Published online by Cambridge University Press:  17 February 2021

V Hema ,
G Rebekah  and
R Kurien
V Hema
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
G Rebekah
Affiliation:
Department of Biostatistics, Christian Medical College, Vellore, India
R Kurien*
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
*
Author for correspondence: Dr Regi Kurien, Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India – 632004 E-mail: regikurien@cmcvellore.ac.in Fax: +91 416 2232035
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Chronic rhinosinusitis is associated with altered mucociliary clearance and olfaction. The study aimed to analyse the reversibility of impairment and endoscopic factors predicting changes in mucociliary clearance and olfactory parameters.

Methods

This prospective study included patients undergoing functional endoscopic sinus surgery for medically refractory chronic rhinosinusitis. Pre- and post-operative measurements of mucociliary clearance, olfactory thresholds, and identification scores were recorded.

Results

Of the 96 patients, 65.6 per cent had polyposis and 80.2 per cent underwent primary surgery. Improvements in mucociliary clearance and olfaction scores were seen in all patients, with greater reversibility of impairment in patients with polyposis and in those who underwent revision surgery. The presence of polyps correlated significantly with changes in mucociliary clearance and olfaction.

Conclusion

The study highlights improvements in mucociliary clearance, olfactory thresholds and identification scores after functional endoscopic sinus surgery in chronic rhinosinusitis with or without nasal polyposis, as well as for primary and revision surgeries. Adequate post-operative care and prevention of polyps recurrence help to improve mucociliary clearance and olfaction scores.

Keywords

Mucociliary ClearanceOlfactionSinusitis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 2 , February 2021 , pp. 147 - 152
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr R Kurien takes responsibility for the integrity of the content of the paper

References

Elwany, S, Hisham, M, Gamaee, R. The effect of endoscopic sinus surgery on mucociliary clearance in patients with chronic sinusitis. Eur Arch Otorhinolaryngol 1998;255:511–14CrossRefGoogle ScholarPubMed
Sakakura, Y, Majima, Y, Saida, S, Ukai, K, Miyoshi, Y. Reversibility of reduced mucociliary clearance in chronic sinusitis. Clin Otolaryngol Allied Sci 1985;10:79–83CrossRefGoogle ScholarPubMed
Litvack, JR, Mace, J, Smith, TL. Does olfactory function improve after endoscopic sinus surgery? Otolaryngol Head Neck Surg 2009;140:312–19CrossRefGoogle ScholarPubMed
Van Cauwenberge, P, Van Hoecke, H, Bachert, C. Pathogenesis of chronic rhinosinusitis. Curr Allergy Asthma Rep 2006;6:487–94CrossRefGoogle ScholarPubMed
Wilson, R, Cole, PJ. The effect of bacterial products on ciliary function. Am Rev Respir Dis 1988;138:S49–53CrossRefGoogle ScholarPubMed
Steinfort, C, Wilson, R, Mitchell, T, Feldman, C, Rutman, A, Todd, H et al. Effect of Streptococcus pneumoniae on human respiratory epithelium in vitro. Infect Immun 1989;57:2006–13CrossRefGoogle ScholarPubMed
Majima, Y, Sakakura, Y, Matsubara, T, Miyoshi, Y. Possible mechanisms of reduction of nasal mucociliary clearance in chronic sinusitis. Clin Otolaryngol Allied Sci 1986;11:55–60CrossRefGoogle ScholarPubMed
Rudmik, L, Smith, TL. Olfactory improvement after endoscopic sinus surgery. Curr Opin Otolaryngol Head Neck Surg 2012;20:29–32CrossRefGoogle ScholarPubMed
Kern, RC. Chronic sinusitis and anosmia: pathologic changes in the olfactory mucosa. Laryngoscope 2000;110:1071–7CrossRefGoogle ScholarPubMed
Singh, M, Chandra, M, Gupta, SC, Sharma, D. Role of measurement of nasal mucociliary clearance by saccharine test as a yard stick of success of functional endoscopic sinus surgery. Indian J Otolaryngol Head Neck Surg 2010;62:289–95CrossRefGoogle ScholarPubMed
Asai, K, Haruna, S, Otori, N, Yanagi, K, Fukami, M, Moriyama, H. Saccharin test of maxillary sinus mucociliary function after endoscopic sinus surgery. Laryngoscope 2000;110:117–22CrossRefGoogle ScholarPubMed
Min, YG, Yun, YS, Song, BH, Cho, YS, Lee, KS. Recovery of nasal physiology after functional endoscopic sinus surgery: olfaction and mucociliary transport. ORL J Otorhinolaryngol Relat Spec 1995;57:264–8CrossRefGoogle ScholarPubMed
Naraghi, M, Baghbanian, N, Moharari, M, Saghazadeh, A. Improvement of sinonasal mucociliary function by endoscopic sinus surgery in patients with chronic rhinosinusitis. Am J Otolaryngol 2018;39:707–10CrossRefGoogle ScholarPubMed
Jiang, RS, Su, MC, Liang, KL, Shiao, JY, Hsin, CH, Lu, FJ et al. Preoperative prognostic factors for olfactory change after functional endoscopic sinus surgery. Am J Rhinol Allergy 2009;23:64–70CrossRefGoogle ScholarPubMed
Fokkens, WJ, Lund, VJ, Mullol, J, Bachert, C, Alobid, I, Baroody, F et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 2012;50:1–12CrossRefGoogle ScholarPubMed
Lund, VJ, Kennedy, DW. Quantification for staging sinusitis. The Staging and Therapy Group. Ann Otol Rhinol Laryngol Suppl 1995;167:17–21CrossRefGoogle ScholarPubMed
Lund, VJ, Mackay, IS. Staging in rhinosinusitis. Rhinology 1993;31:183–4Google Scholar
Andersen, I, Camner, P, Jensen, PL, Philipson, K, Proctor, DF. A comparison of nasal and tracheobronchial clearance. Arch Environ Health 1974;29:290–3CrossRefGoogle ScholarPubMed
Cain, WS, Gent, JF, Goodspeed, RB, Leonard, G. Evaluation of olfactory dysfunction in the Connecticut Chemosensory Clinical Research Center. Laryngoscope 1988;98:83–8CrossRefGoogle ScholarPubMed
Chung, SD, Hung, SH, Lin, HC, Lin, CC. Health care service utilization among patients with chronic rhinosinusitis: a population-based study. Laryngoscope 2014;124:1285–9CrossRefGoogle ScholarPubMed
Kim, YS, Kim, NH, Seong, SY, Kim, KR, Lee, GB, Kim, KS et al. Prevalence and risk factors of chronic rhinosinusitis in Korea. Am J Rhinol Allergy 2011;25:117–21CrossRefGoogle ScholarPubMed
Busaba, NY, Sin, H-J, Salman, SD. Impact of gender on clinical presentation of chronic rhinosinusitis with and without polyposis. J Laryngol Otol 2008;122:1180–4CrossRefGoogle ScholarPubMed
Hopkins, C, Browne, JP, Slack, R, Lund, V, Topham, J, Reeves, B et al. The national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis. Clin Otolaryngol 2006;31:390–8CrossRefGoogle ScholarPubMed
Hirsch, AG, Yan, XS, Sundaresan, AS, Tan, BK, Schleimer, RP, Kern, RC et al. Five-year risk of incident disease following a diagnosis of chronic rhinosinusitis. Allergy 2015;70:1613–21CrossRefGoogle ScholarPubMed
Tan, BK, Chandra, RK, Pollak, J, Kato, A, Conley, DB, Peters, AT et al. Incidence and associated premorbid diagnoses of patients with chronic rhinosinusitis. J Allergy Clin Immunol 2013;131:1350–60CrossRefGoogle ScholarPubMed
Haxel, BR. Recovery of olfaction after sinus surgery for chronic rhinosinusitis: a review. Laryngoscope 2019;129:1053–9CrossRefGoogle ScholarPubMed
Kohli, P, Naik, AN, Farhood, Z, Ong, AA, Nguyen, SA, Soler, M et al. Olfactory outcomes after endoscopic sinus surgery for chronic rhinosinusitis: a meta-analysis. Otolaryngol Head Neck Surg 2016;155:936–48CrossRefGoogle ScholarPubMed
Pade, J, Hummel, T. Olfactory function following nasal surgery. Laryngoscope 2008;118:1260–4CrossRefGoogle ScholarPubMed
Jiang, RS, Lu, FJ, Liang, KL, Shiao, JY, Su, MC, Hsin, CH et al. Olfactory function in patients with chronic rhinosinusitis before and after functional endoscopic sinus surgery. Am J Rhinol 2008;22:445–8CrossRefGoogle ScholarPubMed
Soler, ZM, Sauer, DA, Mace, JC, Smith, TL. Ethmoid histopathology does not predict olfactory outcomes after endoscopic sinus surgery. Am J Rhinol Allergy 2010;24:281–5CrossRefGoogle Scholar
Hauser, LJ, Chandra, RK, Li, P, Turner, JH. Role of tissue eosinophils in chronic rhinosinusitis-associated olfactory loss. Int Forum Allergy Rhinol 2017;7:957–62CrossRefGoogle ScholarPubMed
Hsu, C-Y, Wang, Y-P, Shen, P-H, Weitzel, EK, Lai, JT, Wormald, PJ et al. Objective olfactory outcomes after revision endoscopic sinus surgery. Am J Rhinol Allergy 2013;27:e96–100CrossRefGoogle ScholarPubMed
DeConde, AS, Mace, JC, Alt, JA, Schlosser, RJ, Smith, TL, Soler, ZM. Comparative effectiveness of medical and surgical therapy on olfaction in chronic rhinosinusitis: a prospective, multi-institutional study. Int Forum Allergy Rhinol 2014;4:725–33CrossRefGoogle ScholarPubMed
Danielides, V, Katotomichelakis, M, Balatsouras, D, Riga, M, Simopoulou, M, Kantas, E et al. Evaluation of prognostic factors for olfaction in nasal polyposis treated by endoscopic sinus surgery. Rhinology 2009;47:172–80Google ScholarPubMed
Nguyen, DT, Bey, A, Arous, F, Nguyen-Thi, PL, Felix-Ravelo, M, Jankowski, R. Can surgeons predict the olfactory outcomes after endoscopic surgery for nasal polyposis? Laryngoscope 2015;125:1535–40CrossRefGoogle ScholarPubMed
Katotomichelakis, M, Gouveris, H, Tripsianis, G, Simopoulou, M, Papathanassiou, J, Danielides, V. Biometric predictive models for the evaluation of olfactory recovery after endoscopic sinus surgery in patients with nasal polyposis. Am J Rhinol Allergy 2010;24:276–80CrossRefGoogle ScholarPubMed
Georgalas, C, Videler, W, Freling, N, Fokkens, W. Global Osteitis Scoring Scale and chronic rhinosinusitis: a marker of revision surgery. Clin Otolaryngol 2010;35:455–61CrossRefGoogle ScholarPubMed
Whitcroft, KL, Cuevas, M, Haehner, A, Hummel, T. Patterns of olfactory impairment reflect underlying disease etiology. Laryngoscope 2017;127:291–5CrossRefGoogle ScholarPubMed
Whitcroft, KL, Cuevas, M, Andrews, P, Hummel, T. Monitoring olfactory function in chronic rhinosinusitis and the effect of disease duration on outcome. Int Forum Allergy Rhinol 2018;8:769–76CrossRefGoogle Scholar