CHANGE IN OLFACTORY FUNCTION AFTER ENDOSCOPIC SINUS SURGERY IN PATIENTS WITH CHRONIC RHINOSINU-SITIS AND RELATED INFLUENCING FACTORS

Abstract

Objective To investigate the change in olfactory function after endoscopic sinus surgery in patients with chronic rhinosinusitis (CRS) and related influencing factors. Methods Clinical data were collected from 176 patients with CRS who underwent endoscopic sinus surgery in our hospital from February 2019 to October 2021, and according to the improvement in olfactory function at 3 months after surgery, they were divided into good improvement group with 143 patients and poor improvement group with 33 patients. The two groups were compared in terms of the changes in olfactory function score and objective score before surgery and at 3 months after surgery, and the correlation between preoperative olfactory function score and objective score was analyzed. For the factors with significant differences in the univariate analysis, the multivariate logistic regression model was used to further investigate the independent risk factors for postoperative olfactory function. Results Both groups had significant changes in T&T olfactory score, VAS olfactory score, Lund-Mackay score, and Lund-Kennedy score after treatment (t=2.334,3.943,χ2=8.624,5.568,P<0.05). The Pearson analysis showed that preoperative T&T olfactory score was significantly positively correlated with Lund-Mackay score and Lund-Kennedy score, and VAS olfactory score was also significantly correlated with Lund-Mackay score and Lund-Kennedy score (r=0.651-0.731,P<0.05). There were significant differences between the good improvement group and the poor improvement group in Lund-Mackay score, Lund-Kennedy score, nasal polyps, allergic rhinitis, history of sinus surgery, postoperative complications, and adherence to medical advice after surgery (Z=9.468,3.572,χ2=21.048-41.882,P<0.05). The multivariate logistic regression model analysis showed that postoperative Lund-Mackay scores ≥11.69, Lund-Kennedy scores ≥4.88, presence of nasal polyps, history of allergic rhinitis, history of sinus surgery, and postoperative complications were independently risk factors for poor improvement in olfactory function after surgery in CRS patients, while adherence to medical advice was a protective factor (P<0.05). Conclusion The improvement in olfactory function after endoscopic sinus surgery in CRS patients is associ-ated with multiple factors, among which postoperative Lund-Mackay and Lund-Kennedy scores, presence of nasal polyps, history of allergic rhinitis, history of sinus surgery, and postoperative complications should be taken se-riously in clinical practice, and reasonable treatment measures should be adopted for individualized treatment.

Keywords

• chronic disease|sinusitis|endoscopy|smell|root cause analysis