Effect of modified endoscopic sinus surgery combined with middle turbinate resection on olfactory function and stress response in patients with refractory chronic rhinosinusitis with nasal polyps.

To investigate the effects of modified endoscopic sinus surgery combined with middle turbinate resection on olfactory function and stress response in patients with refractory chronic rhinosinusitis with nasal polyps (CRSwNP).We prospectively selected 92 patients with refractory CRSwNP who were treated in Tianjin 4th Central Hospital from June 2019 to June 2020 as the research subjects. According to the simple randomization of "flipping a coin", they were divided into the observation group (n=50) and the control group (n=42). The observation group was treated with modified endoscopic sinus surgery combined with middle turbinectomy and the control group underwent conventional surgery. The overall response rate, olfactory function, and stress responses of the two groups were compared.A generalized linear model showed that the overall response rate at 2, 4, and 6 months after surgery in the observation group was higher than that in the control group (Wald χ2 group =4.301, Wald χ2 time =91.677, P group =0.038, P time <0.001). Repeated measurements of variance showed no significant differences in olfactory function scores before surgery (P=0.485). After 2, 4, and 6 months, the olfactory function scores of the observation group were higher than those of the control group (P<0.001). After surgery, patients in the observation group had lower Lund-Mackey, Lund-Kennedy, and SNOT-20 scores, and lower epinephrine (E), norepinephrine (NE), and cortisol (Cor) levels than those in the control group (all P<0.001). The observation group had a significantly lower incidence of complications than the control group (10.00% vs. 28.57%, χ2 =5.226, P=0.022).Modified endoscopic sinus surgery combined with middle turbinate resection significantly improved the olfactory function and reduced the perioperative stress response of patients with CRSwNP.