Temporary olfactory improvement in chronic rhinosinusitis with nasal polyps after treatment

Wu, Dawei; Bleier, Benjamin S.; Wei, Yongxiang

doi:10.1007/s00405-018-5066-5

Cited by 25 publications

(18 citation statements)

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“…Transient improvement of olfaction could be achieved after sinus surgery, and olfaction deteriorated with time in some eosinophilic CRS patients but was comparatively sustained well in non‐eosinophilic CRS patients 40 . The persistent elimination of inflammation, especially eosinophilic inflammation, is the target of therapeutic agents to maintain olfactory function 41 . Although oral steroids can achieve olfactory recovery, long‐term use was limited due to systemic side effects.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and cytokine profiles of central‐compartment‐type chronic rhinosinusitis

Lin

Liao

et al. 2021

Int Forum Allergy Rhinol

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Background The clinical characteristics of central‐compartment‐type chronic rhinosinusitis (CRS) in East Asian individuals are not clear. We sought to investigate the clinical features and the cytokine profiles of central‐compartment‐type CRS in our patient group. Methods Adult patients diagnosed with bilateral CRS were recruited, and patients who had previously undergone sinus surgery and pansinusitis (Lund‐Mackay scores >23) were excluded. Central‐compartment‐type CRS was defined by both endoscopic and radiological features. The symptoms, inhalant allergen sensitization status, endoscopic findings, and radiological assessments were recorded and compared between patients with central‐compartment‐type CRS and other types of CRS. We also examined the extent of tissue eosinophilia and specific cytokine protein levels (eosinophil cationic protein [ECP], myeloperoxidase [MPO], immunoglobulin E [IgE], interleukin [IL]‐4, IL‐5, and IL‐13) in the sinonasal tissues. Results Central‐compartment‐type CRS was found in 16 (23.9%) patients, and non–central‐compartment‐type CRS was found in 51 (76.1%) patients. Hyposmia or anosmia as the major symptom was more common in the central‐compartment‐type CRS group. The numbers of eosinophils in tissue and serum were significantly higher in the central‐compartment‐type CRS patients. The presence of allergen sensitization was not significantly different between groups. The levels of IL‐5 and IL‐13 were increased in middle turbinate tissues of patients with central‐compartment‐type CRS. Conclusion Central‐compartment‐type CRS was associated with hyposmia or anosmia, eosinophilic subtypes, and elevated levels of IL‐5 and IL‐13 in middle turbinate tissues but not necessarily correlated with allergic disease in our patients.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics and cytokine profiles of central‐compartment‐type chronic rhinosinusitis

Lin

Liao

et al. 2021

Int Forum Allergy Rhinol

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“…Sinonasal olfactory dysfunction especially chronic rhinosinusitis (CRS) related olfactory dysfunction has been thoroughly studied and a series of distinct clinical features have been identified (Fokkens et al, 2020;Mullol et al, 2020). Peripheral olfactory impairment, olfactory fluctuation, steroid-dependent reverse, a substantial benefit from endoscopic sinus surgery and preserved retronasal olfactory function are the main features of CRS-related olfactory dysfunction (Apter et al, 1999;Stevens, 2001;Kohli et al, 2016a;Whitcroft et al, 2017;Ganjaei et al, 2018;Othieno et al, 2018;Wu et al, 2018Wu et al, , 2020. More importantly, analysis of olfactory subcomponent test score in patients with sinonasal olfactory dysfunction showed that odor threshold score was particularly impaired but odor discrimination and identification was relatively preserved (Whitcroft et al, 2017).…”

Section: Sinonasal Olfactory Dysfunctionmentioning

confidence: 99%

Clinical Implications of Psychophysical Olfactory Testing: Assessment, Diagnosis, and Treatment Outcome

Bleier

Wei

et al. 2021

Front. Neurosci.

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Purpose of ReviewOlfactory dysfunction dramatically impairs quality of life with a prevalence of 20% in the general adult population. Psychophysical olfactory testing has been widely used to evaluate the ability to smell due to its validated utility and feasibility in clinic. This review summarizes the current literature regarding psychophysical olfactory testing and the clinical relevance of the olfactory testing with different components. Furthermore, the review highlights the diagnosis and treatment value of olfactory subtests in patients with olfactory dysfunction.Recent FindingsWith the accumulation of studies of psychophysical olfactory testing in olfactory disorders, the clinical relevance of olfactory testing with different components is expanding. Different olfactory domains present with distinct olfactory processing and cortical activity. Psychophysical assessment of olfaction with three domains reveals different levels of olfactory processing and might assist with analyzing the pathophysiologic mechanism of the various olfactory disorders. Furthermore, olfactory thresholds provided the largest amount of non-redundant information to the olfactory diagnosis. Sinonasal olfactory dysfunction and non-sinonasal-related olfactory dysfunction are emerging classifications of smell disorders with certain characteristics of olfactory impairment and different responses to the therapy including steroids, sinus surgery, and olfactory training.SummaryThese recent advancements should promote the understanding of psychophysical olfactory testing, the association between individual subcomponents and neurophysiological processes, and pave the way for precision assessment and treatment of the olfactory dysfunction.

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“…Several studies found correlations between olfactory cleft inflammatory cytokines/chemokines and olfactory performance in chronic rhinosinusitis patients (Yoo et al 2019). In these patients, altered levels of proinflammatory cytokines including tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in olfactory cleft mucus are associated with reduced olfactory identification scores (Wu et al 2018). Additionally, clinical studies indicate that immunodeficiencies (Magliulo et al 2019) or uncontrolled activation of immune cells occurring in autoimmune diseases (Shin et al 2019) can alter the capacity to smell, typically at the onset of disease.…”

Section: Osn Activity and Inflammation: Roles Of The Immune Systemmentioning

confidence: 99%

Modulation of olfactory signal detection in the olfactory epithelium: focus on the internal and external environment, and the emerging role of the immune system

2021

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Detection and discrimination of odorants by the olfactory system plays a pivotal role in animal survival. Olfactory-based behaviors must be adapted to an ever-changing environment. Part of these adaptations includes changes of odorant detection by olfactory sensory neurons localized in the olfactory epithelium. It is now well established that internal signals such as hormones, neurotransmitters, or paracrine signals directly affect the electric activity of olfactory neurons. Furthermore, recent data have shown that activity-dependent survival of olfactory neurons is important in the olfactory epithelium. Finally, as olfactory neurons are directly exposed to environmental toxicants and pathogens, the olfactory epithelium also interacts closely with the immune system leading to neuroimmune modulations. Here, we review how detection of odorants can be modulated in the vertebrate olfactory epithelium. We choose to focus on three cellular types of the olfactory epithelium (the olfactory sensory neuron, the sustentacular and microvillar cells) to present the diversity of modulation of the detection of odorant in the olfactory epithelium. We also present some of the growing literature on the importance of immune cells in the functioning of the olfactory epithelium, although their impact on odorant detection is only just beginning to be unravelled.

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Temporary olfactory improvement in chronic rhinosinusitis with nasal polyps after treatment

Abstract: The current evidence supports temporary olfactory improvement in CRSwNP patients which accords with the refractory nature of CRSwNP. Future treatment should aim to the continuous elimination of inflammation and promote the normal turnover of the olfactory epithelium.

Cited by 25 publications

References 84 publications

Clinical characteristics and cytokine profiles of central‐compartment‐type chronic rhinosinusitis

Clinical characteristics and cytokine profiles of central‐compartment‐type chronic rhinosinusitis

Clinical Implications of Psychophysical Olfactory Testing: Assessment, Diagnosis, and Treatment Outcome

Modulation of olfactory signal detection in the olfactory epithelium: focus on the internal and external environment, and the emerging role of the immune system

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