European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 12, pp 3367–3372 | Cite as

The treatment efficacy of nasal polyposis on olfactory functions, clinical scoring systems and inflammation markers

  • Zehra Betul Paksoy
  • Melih CayonuEmail author
  • Cigdem Yucel
  • Turan Turhan



The aim of this study was to investigate the effect of the medical and the surgical treatment on the olfactory functions, clinical scoring systems and inflammation markers in patients with nasal polyposis. In addition, the secondary aim was to investigate the correlation between those investigated parameters.

Subjects and methods

A total of 30 patients, who completed the standardized medical and surgical treatment and also came to 3 months of follow-ups regularly after the surgery, were included in the study. The Sniffin’ Sticks olfactory tests, radiological and the endoscopic stagings, liver-expressed chemokine (CCL16) and endothelin (ET) levels and sino-nasal outcome test-22 (SNOT-22) were performed at the initial and at the end of the study.


The current study had four major findings: (1) significant improvement in odor functions after treatment was determined; however, the majority of the patients had been already hyposmic. (2) In addition, significant improvement was found in ET and CCL16 levels, SNOT-22 results, and radiologic and endoscopic stagings at the end of the study. (3) However, there was no correlation between the olfactory functions and the investigated parameters. (4) There was a positive correlation between polyp recurrence and ET levels.


The standardized medical and surgical treatment provided a significant improvement in the olfactory functions. However, only one patient (3.3%) had become normosmic at the end of the study.


Nasal polyposis Sniffin’ sticks Steroid treatment Endoscopic sinus surgery Endothelin CCL16 SNOT-22 



This project was funded by Ankara Numune Training and Research Hospital Scientific Research Projects Directorate by Project Number 1214/2017.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the local Institutional Review Board (Ankara Numune Training and Research Hospital E-16-1127/28.12.2016).


  1. 1.
    Stewart M, Ferguson B, Fromer L (2010) Epidemiology and burden of nasal congestion. Int J Gen Med 8(3):37–45CrossRefGoogle Scholar
  2. 2.
    Banglawala SM, Schlosser RJ, Wenztel J, Walsh T, Overton L, Soler ZM (2016) Trends in chronic rhinosinusitis research in the past three decades. Int Forum Allergy Rhinol 6(1):46–51CrossRefGoogle Scholar
  3. 3.
    Workman AD, Kohanski MA, Cohen NA (2018) Biomarkers in chronic rhinosinusitis with nasal polyps. Immunol Allergy Clin North Am 38(4):679–692CrossRefGoogle Scholar
  4. 4.
    Youn BS, Zhang S, Broxmeyer HE, Antol K, Fraser MJ Jr, Hangoc G, Kwon BS (1998) Isolation and characterization of LMC, a novel lymphocyte and monocyte chemoattractant human CC chemokine, with myelosuppressive activity. Biochem Biophys Res Commun. 247(2):217–222CrossRefGoogle Scholar
  5. 5.
    Hedrick JA, Helms A, Vicari A, Zlotnik A (1998) Characterization of a novel CC chemokine, HCC-4, whose expression is increased by interleukin-10. Blood 91(11):4242–4247CrossRefGoogle Scholar
  6. 6.
    Nakayama T, Kato Y, Hieshima K, Nagakubo D, Kunori Y, Fujisawa T, Yoshie O (2004) Liver-expressed chemokine/CC chemokine ligand 16 attracts eosinophils by interacting with histamine H4 receptor. J Immunol 173(3):2078–2083CrossRefGoogle Scholar
  7. 7.
    Galli SJ, Tsai M (2010) Mast cells in allergy and infection: versatile effector and regulatory cells in innate and adaptive immunity. Eur J Immunol 40(7):1843–1851CrossRefGoogle Scholar
  8. 8.
    Tsybikov NN, Egorova EV, Kuznik BI, Fefelova EV, Magen E (2016) Biomarker assessment in chronic rhinitis and chronic rhinosinusitis: endothelin-1, TARC/CCL17, neopterin, and α-defensins. Allergy Asthma Proc 37(1):35–42CrossRefGoogle Scholar
  9. 9.
    Hancı D, Altun H, Sahin E, Altımtoprak N, Cingi C (2015) Turkish translation, cross-cultural adaptation and validation of the SinoNasal Outcome Test (SNOT)-22. ENT Updates 5(2):51–57CrossRefGoogle Scholar
  10. 10.
    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):39–52CrossRefGoogle Scholar
  11. 11.
    Kobal G, Klimek L, Wolfensberger M, Gudziol H, Temmel A, Owen CM, Seeber H, Pauli E, Hummel T (2000) Multicenter investigation of 1,036 subjects using a standardized method for the assessment of olfactory function combining tests of odor identification, odor discrimination, and olfactory thresholds. Eur Arch Otorhinolaryngol. 257(4):205–211CrossRefGoogle Scholar
  12. 12.
    Wolfensberger M, Schnieper I, Welge-Lüssen A (2000) Sniffin'Sticks: a new olfactory test battery. Acta Otolaryngol 120(2):303–306CrossRefGoogle Scholar
  13. 13.
    Hummel T, Kobal G, Gudziol H, Mackay-Sim A (2007) Normative data for the "Sniffin' Sticks" including tests of odor identification, odor discrimination, and olfactory thresholds: an upgrade based on a group of more than 3,000 subjects. Eur Arch Otorhinolaryngol 264(3):237–243CrossRefGoogle Scholar
  14. 14.
    Lund VJ, Mackay IS (1993) Staging in rhinosinusitis. Rhinology 31(4):183–184PubMedGoogle Scholar
  15. 15.
    Rudmik L, Soler ZM, Hopkins C, Schlosser RJ, Peters A, White AA, Orlandi RR, Fokkens WJ, Douglas R, Smith TL (2016) Defining appropriateness criteria for endoscopic sinus surgery during management of uncomplicated adult chronic rhinosinusitis: a RAND/UCLA appropriateness study. Rhinology 54(2):117–128CrossRefGoogle Scholar
  16. 16.
    Deal RT, Kountakis SE (2004) Significance of nasal polyps in chronic rhinosinusitis: symptoms and surgical outcomes. Laryngoscope 114(11):1932–1935CrossRefGoogle Scholar
  17. 17.
    Pearlman AN, Chandra RK, Chang D, Conley DB, Tripathi-Peters A, Grammer LC, Schleimer RT, Kern RC (2009) Relationships between severity of chronic rhinosinusitis and nasal polyposis, asthma, and atopy. Am J Rhinol Allergy 23(2):145–148CrossRefGoogle Scholar
  18. 18.
    Vento SI, Ertama LO, Hytönen ML, Wolff CH, Malmberg CH (2000) Nasal polyposis: clinical course during 20 years. Ann Allergy Asthma Immunol 85(3):209–214CrossRefGoogle Scholar
  19. 19.
    Kim DW, Kim JY, Jeon SY (2011) The status of the olfactory cleft may predict postoperative olfactory function in chronic rhinosinusitis with nasal polyposis. Am J Rhinol Allergy 25(2):e90–e94CrossRefGoogle Scholar
  20. 20.
    Gupta D, Gulati A, Singh I, Tekur U (2014) Endoscopic, radiological, and symptom correlation of olfactory dysfunction in pre- and postsurgical patients of chronic rhinosinusitis. Chem Senses 39(8):705–710CrossRefGoogle Scholar
  21. 21.
    Jiang RS, Lu FJ, Liang KL, Shiao JY, Su MC, Hsin CH, Chen WK (2008) Olfactory function in patients with chronic rhinosinusitis before and after functional endoscopic sinus surgery. Am J Rhinol 22(4):445–448CrossRefGoogle Scholar
  22. 22.
    Dadgarnia M, Rahmani A, Baradaranfar M, Atighechi S, Zand V, Meybodian M, Mandegari M, Vaziribozorg S (2019) The relationship between endoscopic and radiologic findings and olfactory status of patients with chronic rhinosinusitis with nasal polyps before and after the endoscopic sinus surgery. Eur Arch Otorhinolaryngol 276(2):397–400CrossRefGoogle Scholar
  23. 23.
    Pade J, Hummel T (2008) Olfactory function following nasal surgery. Laryngoscope 118(7):1260–1264CrossRefGoogle Scholar
  24. 24.
    Kern RC, Conley DB, Haines GK 3rd, Robinson AM (2004) Pathology of the olfactory mucosa: implications for the treatment of olfactory dysfunction. Laryngoscope 114(2):279–285CrossRefGoogle Scholar
  25. 25.
    Litvack JR, Mace J, Smith TL (2009) Does olfactory function improve after endoscopic sinus surgery? Otolaryngol Head Neck Surg 140(3):312–319CrossRefGoogle Scholar
  26. 26.
    Hsu CY, Wang YP, Shen PH, Weitzel EK, Lai JT, Wormald PJ (2013) Objective olfactory outcomes after revision endoscopic sinus surgery. Am J Rhinol Allergy 27(4):e96–100CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of OtorhinolaryngologyAnkara Numune Training and Research HospitalAnkaraTurkey
  2. 2.Department of Clinical BiochemistryAnkara Numune Training and Research HospitalAnkaraTurkey

Personalised recommendations