Exploring the impact of inflammatory endotypes on olfactory function and quality of life in chronic rhinosinusitis patients

Abstract

Objectives

The aim of this observational cross-sectional study was to determine the endotypic inflammatory pattern of a sample of patients with CRS in Brazil, correlate it with olfactory function, and evaluate the clinical severity of the disease.

Methods

In this cross-sectional study, 73 CRS patients were recruited. Patients were classified into type 2 and non-type 2 endotypic patterns based on IgE and eosinophilia levels. All subjects performed the University of Pennsylvania Smell Identification Test (UPSIT®) and responded to the Sino-Nasal Outcome Test (SNOT-22).

Results

The majority of patients had type 2 CRS (n = 57, 78.1%). Patients with type 2 CRS compared to non-type 2 CRS had a higher prevalence of nasal polyps (93% vs. 12.5%), asthma (40.3% vs. 12.5%), and non-steroidal anti-inflammatory drug exacerbated respiratory disease (NERD, 17.5% vs. 0%). Type 2 patients also had significantly lower UPSIT® and higher SNOT-22, Lund-Kennedy, and Lund-Mackay scores.

Conclusion

Our study provides evidence that type 2 CRS is associated with a higher prevalence of nasal polyps, asthma, and NERD, as well as decreased olfactory function and worse quality of life scores. These data will contribute to the body of knowledge on CRS and the development of treatments for this disease in Brazil.

Level of evidence: 3.

Keywords
Rhinosinusitis; Olfaction; Quality of life; Endotype

Highlights

Type 2 Chronic Rhinosinusitis (CRS) had more severe disease.

Type 2 CRS had worse olfactory function.

Type 2 CRS had lower quality of life.

Type 2 CRS presented higher Lund-Mackay and Lund-Kennedy scores than non-type 2.

Furthermore, type 2 CRS had a higher prevalence of nasal polyps, asthma, and NERD.