OBJECTIVES: Smell impairment (SI) is a well-known symptom of chronic rhinosinusitis with nasal polyps (CRSwNP). The aim of study was to analyze olfactory and trigeminal event-related potentials (OERPs/TERPs) and psychophysical smell tests in subjects with CRSwNP, and its potential role in clinical practice. METHODS: Prospective study included 57 subjects. Two investigated groups with CRSwNP and one control group. Group I (n = 20) contained subjects without CRSwNP before septoplasty. Group II (n = 18) contained subjects with CRSwNP without therapy. Group III (n = 19) contained subjects with CRSwNP after intranasal corticosteroid therapy. Sniffin stick identification smell test and OERPs/TERPs were performed in all subjects. RESULTS: According to the psychophysical smell test, SI was detected in 65% of subjects with CRSwNP. In the control Group I (without CRSwNP), the absence of OERPs was 5.0%, whilethe mean absence rate in Groups II, III (with CRSwNP) was 8.1%. The highest percentage of absence of OERPs was registered in Group II (11.1%). Absence of TERPs was detected in an average of 21.6% of CRSwNP subjects. Group III showed the highest percentage of absence of TERPs (32%). In the control Group I, TERPs were absent in 0% of subjects. CONCLUSION: CRSwNP significantly impairs olfactory function compared to patients without CRSwNP, Absence of TERPs was detected in an average of 21.6% of CRSwNP subjects versus healthy controls (0%). Presence of TERPs appears to be a predictor of preservation of olfactory function.

1st Faculty of Medicine Charles University and Military University Hospital Prague Department of Neurosurgery and Neurooncology Prague Czech Republic

Charles University 1st Faculty of Medicine Prague Czech Republic

Charles University 2nd Faculty of Medicine Prague Czech Republic

Charles University 3rd Faculty of Medicine Prague Czech Republic

Military Hospital Brno Department of Neurology Brno Czech Republic

Military University Hospital Prague Department of Neurology Prague Czech Republic

Military University Hospital Prague Department of Otorhinolaryngology and Maxillofacial Surgery Prague Czech Republic

Regional Hospital Pardubice Department of Otorhinolaryngology and Head and Neck Surgery Pardubice Czech Republic

University Hospital Motol Department of Ear Nose and Throat Prague Czech Republic

University Hospital Motol Department of Otorhinolaryngology and Head and Neck Surgery Prague Czech Republic

University of Pardubice Faculty of Health Studies Pardubice Czech Republic

See more in PubMed

Alobid I, Benitez P, Pujols L, Maldonado M, Bernal-Sprekelsen M, Morello A, et al. (2006). Severe nasal polyposis and its impact on quality of life. The effect of a short course of oral steroids followed by long-term intranasal steroid treatment. Rhinology 44(1): 8-13.

Bhattacharyya N (2003). The economic burden and symptom manifestations of chronic rhinosinusitis. Am J Rhinol 17(1): 27-32. DOI

Biswas K, Ramakrishnan VR, Hollemann E, Lorenz K, Wagner Mackenzie B, et al. (2023). Bacterial communities in the nasal passage of postviral olfactory dysfunction patients. Int Forum Allergy Rhinol 13(10): 1962-1965. DOI: 10.1002/alr.23149. PubMed DOI

Červený K, Janoušková K, Vaněčková K, Zavázalová Š, Funda D, Astl J, Holý R (2022). Olfactory Evaluation in Clinical Medical Practice. J Clin Med 11(22): 6628. DOI: 10.3390/jcm11226628. PubMed DOI

Corey JP, Gungor A, Nelson R, Fredberg J, Lai V (1997). A comparison of the nasal crosssec-tional areas and volumes obtained with acoustic rhinometry and magnetic resonance imaging. Otolaryngol Head Neck Surg 117(4): 349-354. DOI: 10.1016/S0194- 5998(97)70125-6. DOI

Dekeyser A, Huart C, Hummel T, Hox V (2024). Olfactory Loss in Rhinosinusitis: Mechanisms of Loss and Recovery. Int J Mol Sci 25(8): 4460. DOI: 10.3390/ijms25084460. PubMed DOI

Doty RL, Shaman P, Dann M (1984). Development of the University of Pennsylvania Smell Identification Test: a standardized microencapsulated test of olfactory function. Physiol Behav 32(3): 489-502. DOI: 10.1016/0031-9384(84)90269-5. PubMed DOI

Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. (2020). European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology 58(Suppl S29): 1-464. DOI: 10.4193/Rhin20.600. PubMed DOI

Haxel BR (2019). Recovery of olfaction after sinus surgery for chronic rhinosinusitis: A review. Laryngoscope 129(5): 1053-1059. DOI: 10.1002/lary.27764. PubMed DOI

Holý R, Janoušková K (2024). Objektivní olfaktometrie. In: Voldřich Z, et al. Otorinolaryngologie a foniatrie - Repetitorium. Praha: Galén, p. 210.

Holý R, Janoušková K, Vašina L, Maute E, Kalfeřt D, Mamiňák K, et al. (2023). Olfactory event-related potentials (OERPs) and trigeminal event related potentials (TERPs) - a pilot study in Czech participants with normal sense of smell. J Appl Biomed 21(4): 167-173. DOI: 10.32725/jab.2023.020. PubMed DOI

Holý R, Kalfeřt D, Vašina L, Vorobiov O, Dytrych P, Janoušková K, et al. (2024a). Olfactory event-related potentials (OERPs) and trigeminal event-related potentials (TERPs) in subjects after undergoing Covid-19 infection: single-center prospective study. J Appl Biomed 22(3): 149-154. DOI: 10.32725/jab.2024.020. PubMed DOI

Holý R, Vorobiov O, Janoušková K, Vašina L, Mamiňák K, et al. (2024b). Olfactory event-related potentials and trigeminal event-related potentials - first experience with objective olfactometry in the Czech Republic. Otorinolaryngol Foniatr 73(3): 134-143. DOI: 10.48095/ccorl2024134. DOI

Hopkins C, Gillett S, Slack R, Lund VJ, Browne JP (2009). Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol 34(5): 447-454. DOI: 10.1111/j.1749-4486.2009.01995.x. PubMed DOI

Hu B, Han D, Zhang L, Li Y, Zang H, Wang T, et al. (2010). Olfactory event-related potential in patients with rhinosinusitis-induced olfactory dysfunction. Am J Rhinol Allergy 24(5): 330-335. DOI: 10.2500/ajra.2010.24.3517. PubMed DOI

Hummel T, Liu DT, Müller CA, Stuck BA, Welge-Lüssen A, Hähner A (2023). Olfactory Dysfunction: Etiology, Diagnosis, and Treatment. Dtsch Arztebl Int 120(9): 146-154. DOI: 10.3238/arztebl.m2022.0411. PubMed DOI

Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G (1997). 'Sniffin' Sticks': olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses 22(1): 39-52. DOI: 10.1093/chemse/22.1.39. PubMed DOI

Hummel T, Urbig A, Huart C, Duprez T, Rombaux P (2015). Volume of olfactory bulb and depth of olfactory sulcus in 378 consecutive patients with olfactory loss. J Neurol 262(4): 1046-1051. DOI: 10.1007/s00415-015-7691-x. PubMed DOI

Knížek Z, Vodička J, Brothánková P, Shejbalová H (2017). Čich u pacientů podstupujících endonazální endoskopickou chirurgii [Olfactory function in patients undergoing FESS for chronic rhinosinusitis]. Cas Lek Cesk 156(4): 187-191.

Konstantinidis I, Printza A, Genetzaki S, Mamali K, Kekes G, Constantinidis J (2008). Cultural adaptation of an olfactory identification test: the Greek version of Sniffin' Sticks. Rhinology 46(4): 292-296.

Kovář D, Holý R, Voldřich Z, Fundová P, Astl J (2017). The Contribution of CT Navigation in Endoscopic Sinus Surgery: an Evaluation of Patient Postoperative Quality of Life and Olfaction Function Results. Otorinolaryngol Foniatr 66(4): 205-209.

Lechner M, Fjaeldstad A, Rehman U, Liu J, Boniface D, Boardman J, et al. (2025). The Development and Validation of the Smell-Qx Questionnaire, Based on a Systematic Review of the Literature and the COMET Initiative on the Development of Core Outcome Sets for Clinical Trials in Olfactory Disorders. Int Forum Allergy Rhinol 9: e23604. DOI: 10.1002/alr.23604. PubMed DOI

Litvack JR, Fong K, Mace J, James KE, Smith TL (2008). Predictors of olfactory dysfunction in patients with chronic rhinosinusitis. Laryngoscope 118(12): 2225-2230. DOI: 10.1097/MLG.0b013e318184e216. PubMed DOI

Mamiňák K, Funda D, Zavázalová Š, Filipovský T, Kovář D, Janoušková K, et al. (2024). Mikrobiom a chronická rinosinusitida [The microbiome and chronic rhinosinusitis]. Otorinolaryngol Foniatr 73(3): 182-190. DOI: 10.48095/ccorl2024182. DOI

Mullol J, Mariño-Sánchez F, Valls M, Alobid I, Marin C (2020). The sense of smell in chronic rhinosinusitis. J Allergy Clin Immunol 145(3): 773-776. DOI: 10.1016/j.jaci.2020.01.024. PubMed DOI

Nakanishi M, Brandão PRP, Freire GSM, Vinha LGDA, Fornazieri MA, Anselmo-Lima WT, et al. (2024). Development and validation of the MultiScent-20 digital odour identification test using item response theory. Sci Rep 14(1): 15059. DOI: 10.1038/s41598-024-65915-3. PubMed DOI

Nakashima T, Kidera K, Miyazaki J, Kuratomi Y, Inokuchi A (2006). Smell intensity monitoring using metal oxide semiconductor odor sensors during intravenous olfaction test. Chem Senses 31(1): 43-47. DOI: 10.1093/chemse/bjj004. PubMed DOI

Orlandi RR, Terrell JE (2002). Analysis of the adult chronic rhinosinusitis working definition. Am J Rhinol 16(1): 7-10. DOI

Pastorkova N, Janouskova K, Vasina L, Schulz H, Astl J, Holý R (2023). Postcovid Guillain-Barré syndrome with severe course - case series two patients including clinical evaluation of smell and examination of olfactory event-related potentials (OERPs). Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 168(4): 354-358. DOI: 10.5507/bp.2023.014. PubMed DOI

Pellegrino R, Hähner A, Bojanowski V, Hummel C, Gerber J, Hummel T (2016). Olfactory function in patients with hyposmia compared to healthy subjects - An fMRI study. Rhinolo-gy 54(4): 374-381. DOI: 10.4193/Rhino16.098. PubMed DOI

Psaltis AJ, Li G, Vaezeafshar R, Cho KS, Hwang PH (2014). Modification of the Lund-Kennedy endoscopic scoring system improves its reliability and correlation with patient-reported outcome measures. Laryngoscope 124(10): 2216-2223. DOI: 10.1002/lary.24654. PubMed DOI

Rombaux P, Bertrand B, Keller T, Mouraux A (2007). Clinical significance of olfactory event-related potentials related to orthonasal and retronasal olfactory testing. Laryngoscope 117(6): 1096-1101. DOI: 10.1097/MLG.0b013e31804d1d0d. PubMed DOI

Rombaux P, Mouraux A, Collet S, Eloy P, Bertrand B (2009). Usefulness and feasibility of psychophysical and electrophysiological olfactory testing in the rhinology clinic. Rhinology 47(1): 28-35.

Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, et al. (2015). Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg 152 (2 Suppl): S1-S39. DOI: 10.1177/0194599815572097. PubMed DOI

Schalek P, Otruba L, Hahn A (2010). Quality of life in patients with chronic rhinosinusitis: a validation of the Czech version of SNOT-22 questionnaire. Eur Arch Otorhinolaryngol 267(3): 473-475. DOI: 10.1007/s00405-009-1180-8. PubMed DOI

Soler ZM, Mace J, Smith TL (2008). Symptom-based presentation of chronic rhinosinusitis and symptom-specific outcomes after endoscopic sinus surgery. Am J Rhinol 22(3): 297-301. DOI: 10.2500/ajr.2008.22.3172. PubMed DOI

Stevenson RJ (2010). An initial evaluation of the functions of human olfaction. Chem Senses 35(1): 3-20. DOI: 10.1093/chemse/bjp083. PubMed DOI

Vodička J, Faitlová H, et al. (2012). Poruchy čichu a chuti. Havlíčkův Brod: Tobiáš. Medicína hlavy a krku, 250 p.

Vodicka J, Pellant A, Chrobok V (2007). Screening of olfactory function using odourized markers. Rhinology 45(2): 164-168.

Whitcroft KL, Altundag A, Balungwe P, Boscolo-Rizzo P, Douglas R, Enecilla MLB, et al. (2023). Position paper on olfactory dysfunction: 2023. Rhinology 61(33): 1-108. DOI: 10.4193/Rhin22.483. PubMed DOI

Yuan F, Wu D, Wei Y (2022). Predictive significance of the questionnaire of olfactory disorders-negative statements for olfactory loss in patients with chronic rhinosinusitis. Eur Arch Otorhinolaryngol 279(11): 5253-5262. DOI: 10.1007/s00405-022-07438-z. PubMed DOI

Zhao R, Chen K, Tang Y (2021). Olfactory changes after endoscopic sinus surgery for chronic rhinosinusitis: A meta-analysis. Clin Otolaryngol 46(1): 41-51. DOI: 10.1111/coa.13639. PubMed DOI