Olphactory rehabilitation after nasal polyps endoscopic removal

CILJ STUDIJE: Hiposmija i anosmija česta su manifestacija nosnih polipa. Ciljevi ove studije su utvrditi promjene njuha nakon endoskopske polipektomije te ispitati učinkovitost olfaktorne rehabilitacije mirisnim trakicama kod pacijenata koji imaju hiposmiju ili anosmiju nakon operacije. NACRT STUDIJE: Među pacijentima s nosnim polipima i različitim stupnjem olfaktorne disfunkcije napravljena je prospektivna studija. ISPITANICI I METODE: Uključeno je 50 pacijenata Klinike za otorinolaringologiju i kirurgiju glave i vrata KBC-a Osijek s dijagnozom nosnih polipa i učinjenom endoskopskom polipektomijom, u razdoblju od 1. siječnja do 1. srpnja 2020. godine. Prije operativnog zahvata ispunjavali su strukturirani upitnik vezan za dob, spol, alergiju, pušenje, konzumaciju alkohola i subjektivnu kvalitetu njuha, te su olfaktometrijski testirani metodom mirisnih štapića (Sniffin' Sticks). Nakon endoskopske polipektomije, pacijenti s još uvijek oslabljenim njuhom prolazili su olfaktorni trening od 3 mjeseca udišući mirisne trakice s 4 odoranta različita intenziteta, od najslabijeg prema najjačem, 2 puta dnevno po 10 minuta. Nakon rehabilitacije pacijenti su ponovno olfaktometrijski testirani kako bi se uvidjelo je li došlo do postizanja zadovoljavajućeg njuha. REZULTATI: Zadovoljavajuću kvalitetu njuha (normosmiju) postiglo je 42 % ispitanika uključenih u olfaktornu rehabilitaciju. 53 % ispitanika ostalo je hiposmično, a samo 5 % je ostalo anosmično, pri čemu se rehabilitacija pokazala uspješnijom kod žena u odnosu na muškarce uključene u studiju, kao i kod ispitanika nepušača i ispitanika bez alergija. ZAKLJUČAK: Olfaktorna rehabilitacija putem mirisnih trakica pokazala se relativno uspješnom terapijskom metodom za poboljšanje njuha pacijenata s polipima nakon obavljanja endoskopske polipektomije.OBJECTIVES: Hyposmia and anosmia are frequent manifestations of nasal polyps. This study is aimed to examine changes in olfaction after the endoscopic polypectomy, as well as the efficacy of olfactory rehabilitation with sniffing tracks in patients with hyposmia or anosmia after the performed surgical procedure. STUDY DESIGN: A prospective study was performed among patients with nasal polyps and various quality of olfaction. PARTICIPANTS AND METHODS: The study consisted of overall 50 patients of the Otorhinolaryngological, Head and Neck Surgery Clinic at the Clinical Hospital Centre of Osijek, with confirmed nasal polyposis and performed endoscopic polypectomy in the period from January 1 to July 1 2020. Before the surgical procedure, participants were given a standardised questionnaire, examining age, sex, allergy, smoking, alcohol consumption and subjective impression of their olfaction, followed by olfactometric testing using Sniffin' Sticks method. After the performance of polypectomy, another questionnaire was given out to patients, examining the same factors as the preoperative one, followed by another olfactometric testing. Patients who still suffered from hyposmia and anosmia after endoscopic polypectomy underwent a 3- month olfactory training by sniffing tracks, which contained various concentrations of four different odorants, from the weakest to the strongest-smelling one (vanilla, rose, cloves, garlic), twice a day for 10 minutes. After the rehabilitation, olfactometric testing was performed again, assessing the number of participants achieving the desirable olfactory function. RESULTS: Satisfying olfaction (normosmia) was achieved among 42 % of patients included in the three-month rehabilitation process. 53 % of patients were hyposmic at the end of rehabilitation, mostly with slight improvements of olfactometric testing results, whereas only 5 % of patients remained anosmic after the rehabilitation. The rehabilitation presented itself as more successful among the female participants of the study, as well as among non-smokers and non-allergic participants. CONCLUSION: Olfactory rehabilitation by using sniffing tracks has shown to be a relatively effective and promising method for improvement of olfaction in patients with nasal polyps after the performed endoscopic polypectomy