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Decreased nasal nitric oxide levels: a potential marker of decreased olfactory discrimination in chronic rhinosinusitis

Published online by Cambridge University Press:  27 October 2021

L Zhang
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
F Fang
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Beijing, China
L Yao
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
H Sun
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Beijing, China
X Zhan
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
M Lu
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
Y Wei*
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Capital Institute of Pediatrics, Beijing, China
*
Author for correspondence: Dr Y Wei, Department of Otolaryngology – Head and Neck Surgery, Capital Institute of Pediatrics, Beijing, China E-mail: weiyongxiang6261@163.com

Abstract

Objective

This study aimed to investigate the association of nasal nitric oxide and olfactory function.

Method

A cross-sectional study was performed in 117 adults, including 91 patients with chronic rhinosinusitis and 26 healthy controls. Scores on the 22-item Sino-Nasal Outcomes Test, Lund-Mackay scale and Lund-Kennedy scale were recorded to assess severity of disease. All participants were screened for common inhaled and food allergens. Nasal nitric oxide and fractional exhaled nitric oxide testing, acoustic rhinometry and anterior rhinomanometry testing were performed to measure nasal function. The validated Sniffin’ Sticks test battery was used to assess olfactory function.

Results

Higher nasal nitric oxide was an independent protective factor for odour discrimination and odour threshold in participants with chronic rhinosinusitis after adjusting for age, gender, drinking, smoking, 22-item Sino-Nasal Outcomes Test, Lund-Mackay score, Lund-Kennedy score, immunoglobulin E and the second minimal cross-sectional area by acoustic rhinometry. Nasal nitric oxide also showed high discrimination in predicting impaired odour discrimination. In addition, nasal nitric oxide was lower in older participants, those with higher Lund-Mackay or Lund-Kennedy scores and higher with elevated total serum immunoglobulin E concentrations above a threshold of 0.35 kU/l.

Conclusion

Higher nasal nitric oxide is associated with better odour discrimination in chronic rhinosinusitis and is modulated by age, degree of allergy and severity of chronic rhinosinusitis.

Type
Main Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr Y Wei takes responsibility for the integrity of the content of the paper

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