Persistent asthma has an accumulative impact on the loss of smell in patients with nasal polyposis

Abstract

Background: Loss of sense of smell is one of the most frequent complaints in patients with nasal polyposis (NP). The aim of this study was to evaluate the impact of asthma and its severity on the sense of smell. Material and methods: Patients with massive NP and healthy controls were included. More than half of patients presented with asthma. Olfactometry by Barcelona Smell Test 24, nasal symptoms score, nasal endoscopy, allergy study, and paranasal sinus CT scan were assessed. Results: NP patients showed a significant impairment in smell detection, identification, and forced choice compared to the control. Asthmatics reported lower scores for detection, identification, and forced choice than non-asthmatic patients. Patients with persistent asthma had an increased impairment of sense of smell on detection, identification, and forced choice than patients with intermittent asthma. No significant differences were found between mild, moderate, and severe persistent asthmatics. Paranasal sinuses opacification was inversely correlated with smell detection, identification and forced choice. Conclusion: These findings suggest that patients with NP have an impaired sense of smell, that asthma -particularly persistent asthma- has a further impact on sense of smell, and that loss of smell may be used as a clinical tool to identify the severity of both NP and asthma.

Dupilumab (Dupixent®) tends to be an effective therapy for uncontrolled severe chronic rhinosinusitis with nasal polyps: real data of a single-centered, retrospective single-arm longitudinal study from a university hospital in Germany

“…The frequency of co-occurrence increases again with the severity of the disease [6,29,30]. These patients suffer even more from the symptoms of CRSwNP, as both diseases increase the clinical burden with more severe nasal obstruction and olfactory loss, poorer lung function and asthma control and, and poorer health-related quality of life [31][32][33]. Considering these circumstances, it is even more important for clinicians to identify these patients and provide therapy that treats both conditions.…”

Mepolizumab for chronic rhinosinusitis with nasal polyps (SYNAPSE): a randomised, double-blind, placebo-controlled, phase 3 trial

“…[3][4][5][6] Symptoms of this disease include nasal blockage, loss of smell, facial pressure, and rhinorrhoea, which can have a substantial impact on health-related quality of life. [7][8][9] Current standard of care includes intranasal corticosteroids, short courses of systemic corticosteroids, and nasal surgery. 2 Although systemic corticosteroids reduce the inflammatory response and might temporarily reduce nasal polyp size and improve symptoms, their longterm use is associated with adverse effects.…”

Chronic rhinosinusitis with nasal polyps impact in severe asthma patients: Evidences from the Severe Asthma Network Italy (SANI) registry

“…Chronic rhinosinusitis with nasal polyposis (CRSwNP), a subgroup of chronic rhinosinusitis [1][2][3] of growing importance, is characterized by an impaired health-related quality-of-life (HRQoL), a remarkable symptom burden, a frequent recurrence/relapse [4], and a troublesome and difficult-to-treat olfactory impairment [5][6][7][8]. Recently, the new approach Treatable Traits concept, firstly used in defining respiratory diseases, understanding and treating patients with chronic obstructive pulmonary disease (COPD) and/or asthma, has been also introduced in the CRSwNP context [9].…”