Olfactory disturbance caused by chronic sinusitis

Abstract

Sinusitis has been reported to be one of the major causative etiologies of olfactory disorder. According to our data during last 3 years, 47.5% of all cases of olfactory disorder were attributed to sinusitis. Persistent olfactory disturbance was often critical even after resection of the pathological sinus mucosa by surgery for chronic sinusitis. Accordingly, olfactory epithelial inflammation involved in sinusitis may be considered another important causative factor disturbing the restoration of olfactory acuity. To elucidate this hypothesis, the following experimental and clinical studies were carried out. (1) A morphological study was done with specimens taken from the olfactory cleft of rabbits with experimentally induced sinusitis to analyze the inflammatory effects, and the degree of inflammatory damage was compared, histopathologically between olfactory and respiratory epithelium. SEM observation in the morphological study showed delayed healing in the olfactory portion in comparison with the respiratory portion (p < 0.01). Cell proliferation activity as determined by immunohistochemical study with bromodeoxyuridine (BrdU) was significantly greater in the respiratory area of the cases with sinusitis than in the control (p < 0.01). Cell proliferation status may play a significant role in this delay. (2) Olfaction tests were performed in patients with sinusitis accompanied with olfactory disturbance. In addition to both T&T olfactometry and intravenous olfactometry using fursultiamine (Alinamin Test), Smell Identification Test (SIT) and Threshold Test by graded Phenyl Ethyl Alchol (PEA) were applied to estimate the olfactory acuity of the patients with sinusitis. The results of SIT and PEA tended to parallel not the Alinamin Test but T&T olfactometry. Results showed that the olfactory disorder caused by sinusitis tended to be severe. The results showed that the epithelial factor is important in explaining olfactory disorder etiologically in cases of sinusitis. In particular, olfactory disturbance tended to persist.