Subjective Improvement of Olfactory Function after Endoscopic Sinus Surgery for Chronic Rhinosinusitis

Objective: The purpose of this study was to determine the effect of functional endoscopic sinus surgery (FESS) on subjective olfactory dysfunction in patients with chronic rhinosinusitis. Materials and Methods: Prospective collection of data on consecutive patients undergoing FESS after failing prolonged medical therapy for chronic rhinosinusitis at a tertiary institution. Patients were asked to grade their olfactory dysfunction from 0 to 10, with 0 representing normal function and 10 complete anosmia. In addition, data such as computed tomography scores, presence or absence of nasal polyps, and the presence or absence of asthma were recorded and analyzed. Patients were followed up to 1 year after surgery. Results: Data were collected on 178 patients who had sinus surgery over a 2-year period. The average olfactory dysfunction score before surgery was 4.9. This improved to 0.9 at 1 year after surgery (P = .00). Higher computed tomography scores as per Lund and MacKay correlated with higher olfactory dysfunction scores (r = 0.62, P < .01) and greater improvement after surgery (r = 0.82, P < .01). Asthmatics and patients with polyps had higher subjective olfactory dysfunction scores than nonasthmatics and patients without polyps (6.8 and 7.2 v 4.4 and 4.1, respectively). All groups had subjective improvement at 1 year (2.3 and 1.5 v 0.6 and 0.7, respectively; P = .00). Conclusion: Patients with subjective olfactory dysfunction despite appropriate medical management for rhinosinusitis benefit from FESS.