Smell Decline as a good Predictor of Sinonasal Polyposis Recurrence after Endoscopic Surgery

Abstract

<strong><em>Introduction</em></strong><strong><em>:</em></strong> <br/>To evaluate the most sensitive symptom to predict early recurrence of nasal polyposis. Prospective longitudinal cohort study. Tertiary university referral center with accredited otorhinolaryngology residency programs. <br/><strong><em> </em></strong><strong><em>Materials and Methods</em></strong><strong><em>: </em></strong> <br/>In this prospective study, we evaluated 62 patients with diffuse nasal polyposis. All patients underwent functional endoscopic sinus surgery. The author-devised questionnaire relating to the four major symptoms of chronic rhinosinusitis were answered by patients at the pre-operative visit and at 1, 3, 6, 12, and 24 months after surgery. Patients were followed up with serial endoscopic examinations, and a computed tomography (CT) scan was performed if indicated. <br/><strong><em> </em></strong><strong><em>Results:</em></strong> <br/>All 62 patients (37 male, 25 female) completed the study. The mean age was 41.24 ± 12.47 years. All major symptoms showed significant improvement after surgery (P=0.000); however, the severity of symptoms gradually increased in patients with a recurrence of polyposis, but at different points in time (P= 0.008). Sense of smell was the first symptom to deteriorate in patients with relapse (mean, 6 months) followed by nasal secretion (12 months), obstruction and pain<br clear="all" />(24 months). Patients with asthma, Samter's triad, allergic fungal rhinosinusitis (AFRS) and allergic rhinitis showed symptoms of recurrence sooner than other patients (P<0.05). <br/><strong><em> </em></strong><strong><em>Conclusion:</em></strong><em> </em> <br/>The most sensitive symptom for the early detection of recurrence of nasal polyposis is a decrease in the sense of smell. Nasal obstruction and facial pain were observed in the late stage of relapse when frank polyposis formation was established.