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INTRODUCTION: While olfactory function decreases with age, it is unknown how age affects olfactory training (OT) efficacy. This study compared OT in two cohorts of subjects: aged ≤50 (younger cohort) and aged 51+ (older cohort) with olfactory dysfunction (OD) primarily from COVID-19 infection. METHODS: Subjects with OD primarily secondary to COVID-19 infection were prospectively recruited and enrolled into an OT registry. Baseline data were collected and they were provided with a training kit and asked to complete OT at home twice daily for 6 months. Participants were asked to follow-up at 3 and 6 months during training for olfactory testing and quality-of-life surveys (Sino-Nasal Outcomes Test-22 [SNOT-22] and Questionnaire of Olfactory Disorders Negative Statements [QoD-NS]). RESULTS: Fifty-six participants completed OT (younger cohort: n = 26, older cohort: n = 30). There were no significant differences between cohorts' Affordable Rapid Olfactory Measurement Array (AROMA), QoD-NS, or SNOT-22 scores at any time point. Both cohorts showed significant AROMA score improvement of more than 16 points from baseline to 3 months (younger cohort: p = 0.001; older cohort: p = 0.008). The younger cohort had significant improvements in QoD-NS (p = 0.008) and SNOT-22 (p = 0.042) between baseline and 3 months while the older cohort improved from 3 to 6 months (QoD-NS: p = 0.027, SNOT-22: p = 0.049). CONCLUSION: Both cohorts demonstrated similar significant improvement in olfactory function after 3 months of OT. The timeline of subjective improvement was different between cohorts, with younger patients experiencing earlier improvement.
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INTRODUCTION: Despite effects on quality of life from olfactory and gustatory dysfunction (OD and GD), screening practices are limited, and patients' self-reporting of symptoms remains the only way to understand the burden of chemosensory dysfunction (CSD). Using a large population-based database, we sought to understand factors leading to reduced likelihood of discussing CSD with a provider. METHODS: The 2013â2014 National Health and Nutrition Examination Survey (NHANES) chemosensory protocol was queried for factors influencing discussion of OD/GD with a healthcare provider. Sociodemographic, comorbidity, and objective OD/GD testing results were assessed with a multivariate analysis. RESULTS: Out of 146.1 million US adults, there were an estimated 41.4 million individuals with self-reported OD/GD in the prior 12 months (28.3%). A total of 86.8% of participants did not discuss their problem with a healthcare provider. Men were about half as likely to speak with a healthcare provider (odds ratio [OR] 0.42; 0.26-0.66; p < 0.001) and those with a college education were about nine times more likely to discuss the problem compared to those with less than a ninth-grade educational achievement (OR 8.83; 1.86-41.98; p = 0.02). Those with objective confirmation of CSD were still unlikely to speak with a provider (OR 0.77; 0.44-1.33; p = 0.36). CONCLUSION: Men and those with less education are less likely to discuss OD/GD with a healthcare provider. These populations tend to be at increased risk for CSD, and there are severe downstream health and quality of life implications related to CSD. Dedicated screening and increased public awareness are critical to ensure more equitable care.
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COVID-19, a respiratory illness with a global impact on millions, has recently been linked to manifestations affecting various bodily systems, including the oral cavity. Studies highlight oral issues, like ulcers, blisters, and white patches, alongside olfactory and gustatory dysfunction, influencing an individual's quality of life. In this context, our study aimed to assess the frequency of oral lesions, olfactory and gustatory disorders, and xerostomia resulting from COVID-19. An observational study was conducted with 414 patients to evaluate the frequency of oral symptoms resulting from COVID-19. Patients were diagnosed with mild symptoms and evaluated through clinical examination of the oral cavity and a questionnaire to assess functional alterations. The findings showed that 139 out of 414 patients presented clinical manifestations, with oral lesions being the most prevalent (19.1%), followed by gustatory disorders (18.1%), xerostomia (14.2%), and olfactory dysfunction (14%). The most prevalent oral lesions were ulcerations (n = 51), candidiasis (n = 8), and erythema or red plaques (n = 7). Unfortunately, 50 (12.1%) patients died during this study. Therefore, oral lesions, olfactory and gustatory dysfunctions, and xerostomia are common symptoms associated with COVID-19.
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Objective: This cross-sectional study aimed to determine the epidemiology of olfactory and gustatory dysfunctions related to COVID-19 in China. Methods: This study was conducted by 45 tertiary Grade-A hospitals in China. Online and offline questionnaire data were obtained from patients infected with COVID-19 between December 28, 2022, and February 21, 2023. The collected information included basic demographics, medical history, smoking and drinking history, vaccination history, changes in olfactory and gustatory functions before and after infection, and other postinfection symptoms, as well as the duration and improvement status of olfactory and gustatory disorders. Results: Complete questionnaires were obtained from 35,566 subjects. The overall incidence of olfactory and taste dysfunction was 67.75%. Being female or being a cigarette smoker increased the likelihood of developing olfactory and taste dysfunction. Having received four doses of the vaccine or having good oral health or being a alcohol drinker decreased the risk of such dysfunction. Before infection, the average olfactory and taste VAS scores were 8.41 and 8.51, respectively; after infection, they decreased to 3.69 and 4.29 and recovered to 5.83 and 6.55 by the time of the survey. The median duration of dysosmia and dysgeusia was 15 and 12 days, respectively, with 0.5% of patients having symptoms lasting for more than 28 days. The overall self-reported improvement rate was 59.16%. Recovery was higher in males, never smokers, those who received two or three vaccine doses, and those that had never experienced dental health issues, or chronic accompanying symptoms. Conclusions: The incidence of dysosmia and dysgeusia following infection with the SARS-CoV-2 virus is high in China. Incidence and prognosis are influenced by several factors, including sex, SARS-CoV-2 vaccination, history of head-facial trauma, nasal and oral health status, smoking and drinking history, and the persistence of accompanying symptoms.
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Background The COVID-19 pandemic has led to various health challenges, including the disruption of people's sense of smell. Olfactory disorders have been reported as a lingering consequence of COVID-19, with diverse patterns of smell dysfunction experienced by patients. Objectives This study aimed to investigate the impact of persistent smell disorders on the quality of life of individuals who recovered from COVID-19 in Taif, Saudi Arabia. Methodology A descriptive cross-sectional study was conducted in Taif, Saudi Arabia, between October 2023 and January 2024. The study included adults with a history of PCR-confirmed COVID-19 infection in Taif city. Data were collected using a validated online survey employing a convenience sampling technique. Statistical analysis was carried out using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States), and chi-squared tests were used to assess the relationships. Results The study included 429 participants. A total of 52.7% of the respondents reported a loss of smell after recovering from COVID-19, and 14.9% reported a persistent loss of their sense of smell. The most common types of smell disorders experienced were hyposmia, anosmia, and parosmia. The study revealed emotional distress, changes in eating habits, and social impact among participants with smell disorders. Conclusion This study highlights the high prevalence of persistent smell disorders among individuals who recovered from COVID-19 in Taif, Saudi Arabia. The findings emphasize the complex nature of these disorders and their impact on patients' quality of life. This study contributes valuable information that can inform healthcare practices and support services for individuals experiencing post-COVID-19 smell disorders.
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BACKGROUND: Olfactory dysfunction is a well-known phenomenon in neurological diseases with anosmia and hyposmia serving as clinical or preclinical indicators of Alzheimer's disease, Parkinson's disease, and other neurodegenerative disorders. Since glaucoma is a neurodegenerative disease of the visual system, it may also entail alterations in olfactory function, warranting investigation into potential sensory interconnections. METHODS: A review of the current literature of the last 15 years (from 1 April 2008 to 1 April 2023) was conducted by two different authors searching for topics related to olfaction and glaucoma. RESULTS: three papers met the selection criteria. According to these findings, patients with POAG appear to have worse olfaction than healthy subjects. Furthermore, certain predisposing conditions to glaucoma, such as pseudoexfoliation syndrome and primary vascular dysregulation, could possibly induce olfactory changes that can be measured with the Sniffin Stick test. CONCLUSIONS: the scientific literature on this topic is very limited, and the pathogenesis of olfactory changes in glaucoma is not clear. However, if the results of these studies are confirmed by further research, olfactory testing may be a non-invasive tool to assist clinicians in the early diagnosis of glaucoma.
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Objective: Olfactory dysfunction (OD) represents a frequent complaint in general population and especially in patients with chronic sinonasal diseases. The aim of this study was the cross-cultural adaptation and validation of the Self-reported Mini Olfactory Questionnaire (Self-MOQ) into Italian. Methods: One hundred fifty patients affected by chronic sinonasal diseases and reporting hyposmia were enrolled. Other 150 normosmic subjects without inflammatory or neoplastic sinonasal disorders were used as a control group. The Short-form 36 (SF-36) questionnaire was used for clinical validity. Results: Cronbach's alpha coefficient was 0.825. The test-retest reliability was excellent. The good correlation between the Self-MOQ and the Visual Analogue Scale scores (p < 0.05) demonstrated the construct validity of the questionnaire. The Self-MOQ was able to distinguish between subjects with or without OD (p < 0.05). Higher Self-MOQ score was found in case of nasal obstruction and posterior rhinorrhoea (p < 0.05). Self-MOQ showed significant correlation with SF-36 general health, SF-36 role functioning/physical, and SF-36 pain (p < 0.05). Conclusions: The Italian version of the Self-MOQ showed good internal consistency, test-retest reliability, construct, and clinical validity.
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Trastornos del Olfato , Autoinforme , Humanos , Femenino , Masculino , Italia , Reproducibilidad de los Resultados , Persona de Mediana Edad , Trastornos del Olfato/diagnóstico , Adulto , Anciano , Traducciones , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Olfactory dysfunction (OD) affects many survivors of COVID-19. Prior studies have investigated the use of platelet-rich plasma (PRP) injections for OD. We describe the first randomized controlled trial investigating topical PRP for OD treatment and contribute to existing literature illustrating PRP as an emerging therapeutic. METHODS: This is a single-blinded, randomized controlled trial conducted from July 2022 to December 2023. Adult patients with OD ≥6 months secondary to COVID-19 with Brief Smell Identification Test (BSIT) scores of ≤8/12 or SCENTinel odor intensity of ≤40/100 were included. Patients were randomized to three, monthly PRP or placebo-impregnated Surgifoam treatments into bilateral olfactory clefts. The BSIT, SCENTinel, and Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS) were completed monthly through month 12. RESULTS: Of 104 patients screened, 83 participated. No significant differences in age, OD duration, BSIT, SCENTinel, or QOD-NS scores were found between PRP (n = 42) and placebo (n = 41) patients at baseline. PRP patients experienced a statistically significant increase in BSIT scores from baseline at months 5â9, 11, and 12, while placebo patients did not (p < 0.05). However, total BSIT scores were similar between the two groups throughout the study. Neither the SCENTinel odor intensity scores nor the change from baseline were significantly different between the treatment groups. At month 12, PRP patients experienced minor improvement in OD-related quality-of-life compared with placebo. CONCLUSIONS: This study is the first to describe topical PRP as a safe, experimental treatment for OD in humans. PRP may impact odor identification in post-COVID-19 OD patients, although the lack of difference in total BSIT scores highlights the need for further study.
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COVID-19 , Trastornos del Olfato , Plasma Rico en Plaquetas , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Administración Tópica , COVID-19/terapia , COVID-19/complicaciones , Trastornos del Olfato/terapia , Método Simple Ciego , Resultado del TratamientoRESUMEN
Background: An accessible self-assessment questionnaire is needed to evaluate quality of life in olfactory dysfunction. The need to address this gap led to the development of the brief version of the Questionnaire of Olfactory Disorders (brief QOD), which holds particular value in the context of telemedicine. Objectives: The aim of this study is to examine the reliability and validity of the Arabic brief QOD. Methods: This study included 307 patients suffering from olfactory dysfunction as well as a control group filled a questionnaire including demographic information, the olfaction Visual Analog Scale (VAS), the Sino-nasal Outcome Test 22 (SNOT-22) questionnaire, and the Arabic version of the brief QOD. The Arabic brief QOD's reliability was assessed using Cronbach's α to measure internal consistency. To evaluate test-retest reliability, the intraclass correlation coefficient (ICC) was employed. The discriminative ability: score differences between the two groups were analyzed. The validity Arabic brief QOD was evaluated by comparing it to the olfaction VAS. Results: The Cronbach's α coefficients were 0.757 for Questionnaire of Olfactory Disorders-Parosmia (QOD-P), 0.832 Questionnaire of Olfactory Disorders-quality of life (QOD-QoL), and 0.817 Questionnaire of Olfactory Disorders-visual analog scale (QOD-VAS). The reliability of the overall brief QOD was 0.93. The ICC exceeded the acceptable threshold of 0.7, indicating strong test-retest reliability. The highest correlation was observed between the SNOT-22 and QOD total scores (r = 0.552 and p < .001) as well as between SNOT-22 and QOD VAS (r = 0.512 and p < .001). Conclusion: Excellent validity and reliability have been shown for the Arabic brief QOD as a self-assessment tool assessing quality of life among olfactory dysfunction patients. Level of evidence: NA.
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KEY POINTS: Patients with traumatic brain injury (TBI) had worse olfactory quality of life (QoL) and Sino-Nasal Outcome Test-22 scores compared to a normal cohort. A worse olfactory QoL correlated with concussion symptom burden. Olfactory dysfunction among TBI patients should be addressed to improve overall outcomes.
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Lesiones Traumáticas del Encéfalo , Trastornos del Olfato , Calidad de Vida , Olfato , Humanos , Lesiones Traumáticas del Encéfalo/psicología , Lesiones Traumáticas del Encéfalo/fisiopatología , Lesiones Traumáticas del Encéfalo/complicaciones , Masculino , Trastornos del Olfato/fisiopatología , Trastornos del Olfato/psicología , Trastornos del Olfato/etiología , Adulto , Femenino , Persona de Mediana Edad , Olfato/fisiología , Adulto Joven , Prueba de Resultado Sino-NasalRESUMEN
KEY POINTS: Correlation between symptom-based surveys and objective olfactory testing is variable. For diagnosis and symptom monitoring, surveys should correlate with objective testing. The Odor Awareness Scale (OAS) and Affective Importance of Odor Scale (AIO) showed significant but moderate positive correlations with University of Pennsylvania Scent Identification Test (UPSIT) score.
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Odorantes , Trastornos del Olfato , Olfato , Humanos , Trastornos del Olfato/diagnóstico , Masculino , Femenino , Adulto , Olfato/fisiología , Persona de Mediana Edad , Encuestas y Cuestionarios , Concienciación/fisiología , Anciano , Adulto JovenRESUMEN
OBJECTIVE: This study aimed to evaluate recovery patterns of olfactory dysfunction among recovered COVID-19 patients, both subjective and objective, and correlate this recovery to the severity of the disease. METHODS: The study recruited 200 patients and assigned them to two equal groups, one of them was a control group. The olfactory function of the study group was assessed via subjective and objective methods at baseline and then monthly for three months, with changes in smell function reported at each visit. These patients underwent chemosensory testing using the Sniffin' Sticks test and completed the validated Arabic version of the Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS). RESULTS: Olfactory dysfunction occurred on the first day of COVID-19 symptoms in 37% of participants. Subjective reports suggested smell recovery in 55% after 3 months, but Sniffin' Sticks showed only 1% with normal function, indicating persistent deficits in others. This study revealed smell recovery for 93% of participants (median 14 days), with most (58%) recovering within 2 weeks. No significant links were found between demographics, COVID-smell loss timing, and recovery speed. CONCLUSION: Three months after COVID-19, many patients perceive smell recovery, but objective tests reveal shockingly high rates of persistent dysfunction. Further follow-up with objective tests is vital to assess the true burden and potential long-term effects of smell loss.
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COVID-19 , Trastornos del Olfato , Recuperación de la Función , Humanos , COVID-19/complicaciones , COVID-19/fisiopatología , Masculino , Trastornos del Olfato/etiología , Trastornos del Olfato/fisiopatología , Trastornos del Olfato/virología , Trastornos del Olfato/diagnóstico , Femenino , Persona de Mediana Edad , Estudios Transversales , Adulto , SARS-CoV-2 , Olfato/fisiología , Anciano , Encuestas y Cuestionarios , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: Olfactory perceptions elicited by odors originating from within the body (retronasal olfaction) play a crucial role in well-being and are often disrupted in various medical conditions. However, the assessment of retronasal olfaction in research and the clinical practice is impeded by the lack of commercially available tests and limited standardization of existing testing materials. NEW METHOD: The novel ThreeT retronasal odor identification test employs 20 flavored tablets that deliver a standardized amount of odorous stimuli. The items represent common food- and non-food-related odors. RESULTS: The ThreeT test effectively distinguishes patients with olfactory dysfunction from healthy controls, achieving a specificity of 86% and sensitivity of 73%. Its scores remain stable for up to 3 months (r=.79). COMPARISON WITH EXISTING METHOD: ThreeT test exhibits a strong correlation with "Tasteless powders" measure of retronasal olfaction (r=.78) and classifies people into healthy and patient groups with similar accuracy. Test-retest stability of ThreeT is slightly higher than the stability of "Tasteless powders" (r=.79 vs r=.74). CONCLUSIONS: ThreeT is suitable for integration into scientific research and clinical practice to monitor retronasal odor identification abilities.
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Odorantes , Trastornos del Olfato , Olfato , Comprimidos , Humanos , Femenino , Masculino , Trastornos del Olfato/diagnóstico , Trastornos del Olfato/fisiopatología , Persona de Mediana Edad , Adulto , Olfato/fisiología , Anciano , Percepción Olfatoria/fisiología , Adulto Joven , Sensibilidad y Especificidad , Reproducibilidad de los ResultadosRESUMEN
Taste and smell disorders are common symptoms of SARS-CoV-2 acute infection. In post-COVID-19 condition, symptoms can persist leading to disruption in patients' lives, to changes in their coping skills, and to the need to develop strategies for everyday life. This study aimed to describe the perspective of a group of patients with Long-COVID-19, a condition where loss of taste and/or smell was the most predominant symptom. A qualitative descriptive study was conducted. Participants who had suffered SARS-CoV-2 infection and had Long-COVID-19 loss of taste and/or smell were recruited. Purposive sampling was applied, and participants were recruited until data redundancy was reached. In-depth interviews were used for data collection and thematic analysis was applied. Twelve COVID-19 survivors (75% women) were recruited. The mean age of the participants was 55 years, and the mean duration of post-COVID-19 symptoms was 25 months. Three themes were identified: (a) Living with taste and smell disorders, describing the disorders they experience on a daily basis, how their life has changed and the accompanying emotions, (b) Changes and challenges resulting from the loss of taste and smell, changes in habits, self-care and risk in certain jobs or daily activities, (c) Coping with taste and smell disorders, describing the daily strategies used and the health care received. In conclusion, Long-COVID-19 taste and/or smell disorders limit daily life and involve changes in habits, meal preparation, and the ability to detect potentially dangerous situations.
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OBJECTIVES: To assess the experience of subjects with olfactory disorders in their daily life and medical management, and their expectations and proposals for improvement. MATERIAL AND METHODS: A cross-sectional observational study was conducted over the period January 2020 to December 2021, with 300 subjects with olfactory disorders: 222 female, 78 male; mean age 46±15 years. In total, 126 were patients consulting in ENT, and 174 were members of the Anosmie.org patients' association. Participants filled out a questionnaire; free texts were analyzed thematically and coded for various qualitative variables. RESULTS: Olfactory disorders considerably impacted health, safety and quality of life. Non-COVID-19 acute etiologies (non-COVID-19 viral infection, cranial trauma) showed particularly high risk of psychological, social, safety-related and nutritional consequences. Almost all patients (94%) were dissatisfied with their medical management: 28% had received little explanation, and 23% felt their dysosmia was completely neglected, with no exploration and no etiology suggested. Patients wished above all to have follow-up and accompaniment. CONCLUSION: Despite significant impact on health and quality of life, olfactory disorders are neglected by the medical community. Patients should be given an ENT assessment with olfactometry, to establish diagnosis and prognosis. Global multidisciplinary management is necessary, including therapeutic education, and psychological, social and nutritional follow-up.
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Trastornos del Olfato , Calidad de Vida , Humanos , Femenino , Masculino , Persona de Mediana Edad , Trastornos del Olfato/etiología , Estudios Transversales , Francia , Adulto , Anciano , Satisfacción del Paciente , Encuestas y CuestionariosRESUMEN
BACKGROUND AND OBJECTIVE: Olfactory disorders in COVID-19 impact quality of life and may lead to psychological impairments. Prevalence ranges from 8 to 85%, persisting in about 30% of cases. This study aimed to evaluate the 6-month post-COVID-19 impact on quality of life, hedonic experiences, anxiety and depression due to olfactory disorders. Additionally, it sought to compare psychophysical tests and self-perceived olfactory evaluations. METHODS: A prospective, longitudinal study was conducted over baseline (T0) and 6 months (T1) on individuals with persistent olfactory disorders post-COVID-19 for more than 6 weeks. Psychophysical tests employed the Sniffin' Sticks Test® (TDI score), and self-perceived olfactory evaluation used a Visual Analogue Scale. Quality of life was assessed with an Olfactive Disorder Questionnaire and the French version of the Quality of Life and Diet Questionnaire. Hedonic experiences were gauged using the Snaith-Hamilton Pleasure Scale, while anxiety and depression dimensions were measured by The State-Trait Anxiety Inventory, The Post Traumatic Stress Checklist Scale, and Hamilton Rating Scale for Depression. Participants were classified into the "normosmic group" (NG) and the "olfactory disorders group" (ODG) at T0 and T1 based on the TDI score. RESULTS: Were included 56 participants (58.93% women, 41.07% men) with a mean age of 39.04 years and a mean duration of post-COVID-19 olfactory disorders of 5.32 months. At T1, ODG had a significantly lower quality of life and hedonic experiences than NG. No significant differences in anxiety and depression dimensions were observed between groups. At T0, psychophysical tests and self-perceived olfactory evaluations were significantly correlated with quality of life and hedonic experiences in both groups. At T1, self-perceived olfactory evaluation in NG correlated significantly with quality of life, hedonic experiences, anxiety and depression dimensions, whereas ODG only correlated with hedonic experiences. CONCLUSION: Individuals with persistent post-COVID-19 olfactory disorders after six months demonstrated compromised quality of life and hedonic experiences. Self-perceived olfactory evaluation played a more significant role in influencing quality of life and the dimension of anxiety and depression than the psychophysical presence of olfactory disorders. These findings emphasize the importance of considering patients' perceptions to comprehensively assess the impact of olfactory disorders on their well-being. TRIAL REGISTRATION: ClinicalTrials.gov number (ID: NCT04799977).
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COVID-19 , Trastornos del Olfato , Masculino , Humanos , Femenino , Adulto , Estudios Prospectivos , Calidad de Vida , Estudios Longitudinales , Trastornos del Olfato/psicologíaRESUMEN
BACKGROUND: Recovery of olfactory function plays a prominent role in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). While rates and timing of such recovery vary, monoclonal antibodies might yield better results which we aimed at evaluating with this study. METHODOLOGY: A prospective controlled study was conducted at our tertiary otolaryngological center from April 1, 2021, to October 1, 2022, in CRSwNP patients. We included an active group (n = 60 patients) performing dupilumab treatment and a control group (n = 60 patients) treated with intranasal and oral corticosteroids. Primary endpoints were changes in smell visual analogical scale (VAS) and SS-I (Sniffin' Sticks-identification) scores, and olfactory recovery rate. The secondary efficacy endpoints were nasal obstruction, rhinorrhea, headache, SNOT-22, and nasal congestion score (NCS). RESULTS: At 6 months, the active group demonstrated better outcomes than control in SS-I scores (10.23 ± 4.21 vs.3.68 ± 3.08; p < 0.001). No significant differences were found in blood eosinophil count, SNOT-22, and NPS (p > 0.05 for all). Olfactory function in the treatment arm improved in 86.66% (52/60 cases), with normal scores in 48.33% (29/60), while the control group reported a lower recovery rate (3/60; 5%), with no normal olfaction cases. Log-rank comparison for Kaplan-Meier functions was statistically significant (p < 0.001), but no differences were found in subanalysis in the active group based on blood eosinophil count at baseline, SNOT-22, and NPS scores. CONCLUSIONS: Patients who receive dupilumab treatment may experience a faster recovery of olfactory function compared to those receiving corticosteroid therapy. This result would be maintained regardless of the severity of type 2 CRSwNP inflammation, the volume of the polyps, or the patient's subjective symptomatology.
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Pólipos Nasales , Rinitis , Sinusitis , Humanos , Estudios Prospectivos , Rinitis/complicaciones , Rinitis/tratamiento farmacológico , Rinitis/cirugía , Sinusitis/complicaciones , Sinusitis/tratamiento farmacológico , Sinusitis/cirugía , Anticuerpos Monoclonales Humanizados/uso terapéutico , Pólipos Nasales/complicaciones , Pólipos Nasales/tratamiento farmacológico , Pólipos Nasales/cirugía , Enfermedad Crónica , Calidad de VidaRESUMEN
INTRODUCTION: Olfactory dysfunction (OD) is common among people with cystic fibrosis (PwCF). The Questionnaire of Olfactory Disorders (QOD) is a validated instrument that evaluates olfactory-specific quality-of-life. The QOD minimal clinically important difference (MCID) and factors associated with olfactory improvement after elexacaftor/tezacaftor/ivacaftor have not been determined for PwCF. METHODS: Prospective observational data were pooled from three studies that enrolled adult PwCF with chronic rhinosinusitis (CRS). QOD scores and disease characteristics were assessed. To evaluate internal consistency and calculate the QOD MCID, Cronbach's alpha and four distribution-based methods were employed. For participants who enrolled prior to elexacaftor/tezacaftor/ivacaftor, QOD scores were obtained at baseline and after elexacaftor/tezacaftor/ivacaftor initiation. Multivariable regression was used to identify factors associated with QOD improvement. RESULTS: Of 129 PwCF included, 65 had QOD scores before and 3-6 months after starting elexacaftor/tezacaftor/ivacaftor. Mean baseline QOD score was 6.5 ± 7.9. Mean Cronbach's alpha was ≥0.85. The MCID estimates were as follows: Cohen's effect size = 1.6, standard error of measurement = 2.5, ½ baseline standard deviation = 4.0, and minimal detectable change = 6.9. Mean MCID was 3.7. Of those with pre/post elexacaftor/tezacaftor/ivacaftor QOD scores, the mean change in QOD was -1.3 ± 5.4. After elexacaftor/tezacaftor/ivacaftor, QOD improvement surpassed the MCID in 22% of participants (14/65). Worse baseline QOD scores and nasal polyps were associated with improved QOD scores after elexacaftor/tezacaftor/ivacaftor (both p < 0.04). CONCLUSION: The QOD MCID in PwCF was estimated to be 3.7. Elexacaftor/tezacaftor/ivacaftor led to qualitative but not clinically meaningful improvements in QOD score for most PwCF; PwCF with worse baseline QOD scores and nasal polyps improved in a clinically significant manner.
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Aminofenoles , Benzodioxoles , Fibrosis Quística , Indoles , Diferencia Mínima Clínicamente Importante , Trastornos del Olfato , Humanos , Fibrosis Quística/tratamiento farmacológico , Fibrosis Quística/complicaciones , Masculino , Femenino , Adulto , Aminofenoles/uso terapéutico , Encuestas y Cuestionarios , Indoles/uso terapéutico , Benzodioxoles/uso terapéutico , Trastornos del Olfato/tratamiento farmacológico , Piridinas/uso terapéutico , Quinolonas/uso terapéutico , Calidad de Vida , Combinación de Medicamentos , Rinitis/tratamiento farmacológico , Sinusitis/tratamiento farmacológico , Estudios Prospectivos , Enfermedad Crónica , Pirazoles/uso terapéutico , Adulto Joven , Resultado del Tratamiento , Persona de Mediana Edad , PirrolidinasRESUMEN
PURPOSE OF REVIEW: To review the effects of endoscopic sinus surgery and endonasal approaches to the skull base on olfaction. RECENT FINDINGS: Advancements in endonasal endoscopic approaches to the sinuses and skull base allow for direct treatment of a variety of sinonasal and skull base diseases. However, these extended approaches will often require manipulation of normal anatomical structures and the olfactory neuroepithelium. Depending on the planned procedure and extent of disease, the prognosis of olfactory perception can vary significantly among patients. Endoscopic sinonasal surgical procedures may impact olfaction. Optimizing olfactory function requires proper surgical techniques, gentle handling of tissue, and perioperative care. Surgeons must discuss objectives and manage patient expectations. Routine olfactory assessment is crucial in surgical work-up and follow-up. Preserving anatomical structures while addressing the obstruction of the olfactory cleft helps to prevent decreased olfactory threshold. However, smell identification and discrimination do not always correlate with sinonasal anatomy.