Olfactory Function Improvement in Chronic Rhinosinusitis
Summary
Chronic rhinosinusitis (CRS) often leads to olfactory dysfunction, diminishing quality of life and daily satisfaction with taste and smell. Improvement of olfactory function in CRS is a key therapeutic goal, guided by an understanding of the underlying inflammatory pathways, structural obstruction and neuronal regeneration capacity. Type 2 eosinophilic inflammation at the olfactory epithelium plays a central role in sensory loss, driving cytokine-mediated damage to olfactory sensory neurons and basal progenitor cells. Treatments aim to restore airflow and reduce mucosal inflammation through a combination of topical and systemic corticosteroids, functional endoscopic sinus surgery (FESS) and targeted biologics. Emerging evidence supports the value of precision medicine, where preoperative assessment of olfactory threshold and imaging informs patient selection for surgery, predicts recovery potential and tailors postoperative management including saline irrigation, steroid rinses and olfactory training. Advances in biotherapeutics against interleukins such as IL-5, IL-4/13 and IgE have demonstrated promising rates of olfactory recovery, particularly in refractory nasal polyposis. Collectively, these multidisciplinary strategies illustrate global strides towards restoring smell in CRS patients by addressing both mucosal pathology and neural repair mechanisms.
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Olfactory Function Improvement in Chronic Rhinosinusitis publication trend
The graph below shows the total number of articles in olfactory function improvement in chronic rhinosinusitis across all publications each year (not limited to Nature Index journals).
Technical terms
Chronic rhinosinusitis (CRS): Persistent inflammation of the nasal and paranasal sinus mucosa lasting more than 12 weeks.
Olfactory dysfunction: Impaired sense of smell ranging from reduced sensitivity (hyposmia) to complete loss (anosmia).
Type 2 inflammation: Immune response driven by eosinophils and cytokines such as IL-4, IL-5 and IL-13, common in CRS with nasal polyps.
Olfactory epithelium: Specialized nasal tissue containing sensory neurons responsible for detecting odours.
Endoscopic sinus surgery (FESS): Minimally invasive procedure to remove inflammatory tissue and polyps, improving sinus ventilation.
Biotherapeutics: Monoclonal antibodies targeting specific cytokines or immunoglobulins to modulate key inflammatory pathways.
References
- Sense of smell in chronic rhinosinusitis: A multicentric study on 811 patients. Frontiers in Allergy (2023).
- Presurgical olfactory function as an indicator of the outcome of functional endoscopic sinus surgery in chronic rhinosinusitis with nasal polyps. European Archives of Oto-Rhino-Laryngology (2022).
- Machine-Learning Points at Endoscopic, Quality of Life, and Olfactory Parameters as Outcome Criteria for Endoscopic Paranasal Sinus Surgery in Chronic Rhinosinusitis. Journal of Clinical Medicine (2021).
- Apoptosis and turnover disruption of olfactory sensory neurons in eosinophilic chronic rhinosinusitis. Frontiers in Cellular Neuroscience (2024).
- Olfactory Loss in Rhinosinusitis: Mechanisms of Loss and Recovery. International Journal of Molecular Sciences (2024).
- Recovery of smell sense loss by mepolizumab in a patient allergic to Dermatophagoides and affected by chronic rhinosinusitis with nasal polyps. Clinical and Molecular Allergy (2019).
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