Predictive value of disease severity on self-reported rating and quantitative measures of olfactory function outcomes after primary endoscopic sinus surgery. A prospective study

Background: This prospective study investigates the influence of primary Endoscopic Sinus Surgery (ESS) in patients with chronic rhinosinusitis (CRS) on olfactory function and on the patients' quality of life. We assess the role of preoperative disease severity measured by computed tomography (CT) scan in predicting outcome. Methodology: Adults undergoing ESS were examined preoperatively (n=92) and five months postoperatively. Coronal CT scans were evaluated referencing the Lund Mackay (LM) system. On the basis of the LM score, the collective was divided into two groups. We performed the olfactory test "Sniffin' Sticks" and handed out the specific health-related quality of life questionnaire SNOT-20. Results: We could demonstrate that olfactory function of patients with strong opacification on CT scans improved by an average of 2.49 points more than olfactory function of patients with less severe disease. In terms of the self-reported rating of smell, the degree of amelioration differed significantly. Both groups showed an improvement in quality of life irrespective of severity of disease. Conclusion: Mean olfactory function of patients with a high degree of disease in CT scan improved more than that of patients with less opacification on CT scan. Patient's subjective perception of smell impairment was in line with these findings.