Posterior Rhinorrhea Research Articles

Mild and symptom-free months in patients with chronic rhinosinusitis with nasal polyps treated with dupilumab

BackgroundFrequently reported outcomes of clinical trials in chronic rhinosinusitis with nasal polyps (CRSwNP) may have limited relatability for patients. ObjectiveTo enhance the patient relatability of outcomes in dupilumab clinical trials for CRSwNP, daily symptom scores were used to determine new patient‑centered end points: mild-to-no-symptom months (MSM) and symptom-free months (SFM). MethodsThis work is a post hoc analysis of patients receiving dupilumab 300 mg or placebo every 2 weeks for 24 weeks (SINUS-24 study; NCT02912468) or 52 weeks (SINUS‑52; NCT02898454). Patients recorded symptom severity scores daily for each of nasal congestion, loss of smell, and anterior and posterior rhinorrhea on a scale of 0 to 3 (0 = no symptoms; 1 = mild; 2 = moderate; 3 = severe). We assessed the proportions of patients reporting only MSM or SFM throughout the 28‑day period before randomization, week 24 (pooled studies), and week 52 (SINUS‑52). ResultsSignificantly more dupilumab‑treated than placebo-treated patients achieved MSM for all 4 symptoms (week 24: 31.0% vs 4.4%; odds ratio [OR] 12.9 [95% CI 6.4-25.8]; week 52: 38.3% vs 2.6%; OR 15.6 [5.9-41.0]; both P < .0001). In addition, significantly more dupilumab-treated than placebo‑treated patients achieved SFM for at least 1 of the 4 symptoms (week 24: 35.4% vs 10.8%; OR 4.9 [95% CI 3.1-7.8]; week 52: 50.0% vs 9.2%; OR 9.1 [95% CI 4.6-17.9]; both P < .0001). ConclusionOne-third of patients with severe CRSwNP treated with dupilumab achieved MSM for all 4 cardinal symptoms (nasal congestion, loss of smell, and anterior and posterior rhinorrhea). Moreover, half of the patients achieved SFM for at least 1 of the 4 symptoms. These results support the benefit of dupilumab in improving patient‑centered outcomes. Trial RegistrationClinicalTrials.gov Identifiers: NCT02912468 (SINUS-24) and NCT02898454 (SINUS-52).

The Incidence of Radiologic Evidence of Sinusitis Following Endoscopic Pituitary Surgery: A Multi-Center Study.

Background: Endoscopic endonasal skull base surgery has become a viable alternative to open procedures for the surgical treatment of benign and malignant lesions in the sinonasal and skull base regions. As in sinus surgery, skull base surgery may cause crusting and posterior rhinorrhea, particularly when a nasoseptal flap is required for skull base reconstruction. Post-operative radiological sinonasal findings have been reported previously with no clear correlation with intraoperative decision-making. As in open surgery, endoscopic surgery is not standardized and there is variability in the intervention to assist with exposure and skull base repair. These modifications, including middle turbinate resection, nasoseptal flap, fat graft, and maxillary antrostomy have the potential for nasal morbidity. The aim of this study was to evaluate whether specific interventions during surgery or specific patient and tumor characteristics harbor a more significant risk of causing nasal morbidity post-operatively, as demonstrated by post-operative imaging. Methods: A retrospective analysis of all patients who underwent endoscopic endonasal skull base surgery for pituitary lesions at two major referral centers was performed. Data on demographic, clinical, and pathological features were collected, and pre- and post-operative imaging studies (computed tomography (CT) and magnetic resonance imaging (MRI)) were reviewed and scored according to the Lund-Mackay (LM) scoring system. Results: The study included 183 patients. Radiographic evidence of sinusitis was observed in 30 patients (LM score > 4) in post-operative imaging studies. Patients who underwent middle turbinectomy or nasoseptal flap were found to have significantly higher LM scores on follow-up imaging. A nasoseptal flap was found to be associated with an average increase in LM score of 1.67 points and middle turbinectomy with an average increase of 2.21 points. There was no correlation between tumor size and findings that were compatible with sinusitis on post-operative imaging. Conclusions: The findings of the present study suggest that endoscopic endonasal skull base surgery is associated with radiological evidence of sinusitis. Nasoseptal flap reconstruction and middle turbinectomy were strongly associated with radiographic sinusitis and should be judiciously performed during surgery. A clinical correlation is needed for further recommendations.

Surgical Endoscopic Treatment of Odontogenic Sinusitis.

Introduction: Odontogenic sinusitis is a frequent disease of the maxillary sinus, resulting from a dental inflammatory condition or a foreign body migrated in the sinus cavity. We performed a clinical retrospective study aimed to review the two surgical endoscopic approaches for odontogenic maxillary sinusitis middle and inferior meatotomy, in terms of realistic indications, efficacy, outcomes, and possible complications. Materials and Methods: In our study, we included a number of 400 patients with odontogenic maxillary sinusitis divided into two groups, treated in our hospital over five years, from January 2019 to December 2023. The patients included in this research were over 18 years old, diagnosed with odontogenic maxillary sinusitis, and underwent either middle meatal antrostomy or inferior meatotomy. Results: We examined the medical records of 400 patients. The vast majority of patients had a history of dental interventions, and the most affected tooth was the first maxillary molar. The symptoms at admission were typical for sinusitis: nasal obstruction, anterior or posterior rhinorrhea, hyposmia to anosmia, cacosmia, and pain or facial pressure. 80% of the patients in the study underwent middle meatal antrostomy, while 20% underwent inferior meatotomy. There were no significant differences between these two approaches in terms of efficacy, complication rates, recovery, or relapses. The complications that occurred after the surgical treatment were minor and with a very low frequency. The most reported were middle meatus synechiae and the persistence of the meatotomy ostium, with mucus recirculation (in patients with inferior meatotomy). Conclusions: Endoscopic surgical treatment of odontogenic maxillary sinusitis can be done as middle or inferior meatotomy, each having specific indications. The maxillary antrostomy is preferred in the majority of cases, as it is a procedure in which the natural ostium of the maxillary sinus is enlarged, thereby maintaining the natural drainage pathway of the sinus. However, the inferior meatotomy is preferred in the case of foreign bodies or maxillary sinus retention cysts localized at the level of the sinus floor or in the alveolar or lateral recesses, or as part of a combined approach (inferior and middle meatotomy), when the ablation of a "fungus ball" is required.

Subdural empyema as a complication of odontogenic sinusitis: A case report

Odontogenic sinusitis represents between 10 and 40% of all cases of sinusitis in the population and may present with common symptoms such as nasal obstruction, anterior or posterior rhinorrhea, facial pain or pressure; and hypo- or anosmia. Although uncommon, intracranial and systemic suppurative complications have been previously reported in the literature and include brain abscess, epidural abscess and subdural empyema, associated with almost 100% morbidity and mortality, however, they are commonly related to meningitis, otogenic diseases and other sinus diseases. The aim of this study was to report a clinical case of intracranial subdural empyema associated with odontogenic infection in a previously healthy 17-year-old patient. This case highlighted the possibility of relevant complications, including even the patient's death, due to odontogenic sinusitis. Therefore, early dental planning and approach in a hospital environment are relevant and essential both in prevention and in the course of treatment, substantiating the multidisciplinary approach.

Minimal clinically important differences on the DyNaChron questionnaire after surgery

ObjectivesTo determine minimal clinically important differences (MCIDs) for the DyNaChron chronic rhinosinusitis quality-of-life questionnaire. IntroductionMCIDs are the smallest changes in a quality-of-life score that are of clinical relevance for the patient. They allow treatment benefit to be estimated. MCIDs have not previously been determined for DyNaChron. Material and methodsA single-center retrospective study analyzed DyNaChron questionnaires filled out between June 2016 and December 2021 by all patients consulting for chronic nasal dysfunction. Five hundred and thirteen of the 2390 patients were operated on for nasal polyposis (NP; n=282) or septo(rhino)plasty+inferior turbinoplasty (SPIT; n=231). Standard error of measurement was used to determine MCIDs. ResultsMCID for DyNaChron global score was 60 in NP and 58 in SPIT. MCIDs per symptom domain in NP and SPIT respectively were: 15 and 13 for nasal obstruction, 21 and 21 for anterior rhinorrhea, 20 and 19 for posterior rhinorrhea, and 17 and 17 for olfaction. In agreement with global MCID, 257 NPs (91%) and 149 SPITs (65%) showed clinical improvement. ConclusionMCID helps assess response to treatment. In the DyNaChron questionnaire, MCIDs enable global and symptom-specific assessment of chronic nasal dysfunction and its impact on quality of life in a single patient or in groups.

Proposal for a new diagnostic-therapeutic algorithm in chronic rhinosinusitis with nasal polyps.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the nose and the paranasal sinuses characterized by the presence of nasal polyps and persistent symptoms of nasal obstruction, anterior or posterior rhinorrhea, facial pain or pressure, and reduction or loss of smell, lasting longer than 12 weeks. Several therapeutic strategies are nowadays available to treat CRSwNP as a function of disease severity. However, a standardized therapeutic algorithm has not yet been proposed. Since CRSwNP severity can be assessed by the Clinical-Cytological Grading (CCG) and the consequent reduction in patients' Quality of Life can be defined with the Sino Nasal Outcome Test-22 (SNOT-22), we aimed to propose a new diagnostic-therapeutic algorithm, that takes into consideration both the characteristics of the patients, including the CCG, nasal obstruction, and SNOT-22, and all the therapies available today.

Improvement of Eosinophilic Rhinosinusitis Headache after Endoscopic Modified Lothrop Procedure: Case Report and Literature Review

The main symptoms of eosinophilic chronic rhinosinusitis are olfactory disturbances, nasal obstruction and posterior rhinorrhea. chronic rhinosinusitis cases, only few reports have described an association between eosinophilic chronic rhinosinusitis and headache.

Omalizumab and quality of life in nasal polyps: A post hoc analysis.

Omalizumab and quality of life in nasal polyps: A post hoc analysis.

Rapid and sustained effects of dupilumab in severe chronic rhinosinusitis with nasal polyps.

Rapid and sustained effects of dupilumab in severe chronic rhinosinusitis with nasal polyps.

Expert Opinion on Biological Treatment of Chronic Rhinosinusitis with Nasal Polyps in the Gulf Region.

Chronic rhinosinusitis (CRS) is defined as the inflammation of nose and paranasal sinuses, affecting the patients’ quality of life and productivity. Chronic rhinosinusitis with nasal polyps (CRSwNP) is a principal clinical entity confirmed by the existence of chronic sinonasal inflammation and is characterized by anterior or posterior rhinorrhea, nasal congestion, hyposmia and/or facial pressure or facial pain. Several epidemiologic studies have revealed wide variations in the incidence of CRS among regions globally ranging from 4.6% to 12%. The Gulf countries are also witnessing an unprecedented burden of CRSwNP. According to the current clinical guidelines, glucocorticosteroids and antibiotics are the principal pharmacotherapeutic approaches. Endoscopic sinus surgery is recommended for those who have failed maximal pharmacotherapy. Recently, biologics are considered as an alternative best approach due to the complications associated with medical therapy and surgery. However, precise data on the clinical position of biologic agents in the management of CRSwNP in the Gulf region is not available. The present review article addresses the current diagnostic and management approaches for CRSwNP and also emphasizes the role of emerging biologics in the current treatment strategies for CRSwNP in the Gulf region. Further, a consensus protocol was convened to rationalize the guideline recommendations, strategize the best practices with biologics, and develop clinical practice guidelines for all primary-care specialists in the Gulf region. The consensus-based report will be a useful reference tool for primary-care physicians in primary-healthcare settings, regarding the appropriate time for the initiation of biological treatment in the Gulf region.

Primitive Cavum Tuberculosis: An Unusual Location of Mycobacteria

<i>Objective:</i> This is a 17-year-old patient with no known history who had consulted the ENT department of the CHU-Gabriel Touré for persistent obstruction of the right nose. Its clinical history dates back to approximately 03 years, marked by a unilateral right nasal obstruction of progressive installation and permanent evolution associated with purulent posterior rhinorrhea, anosmia, right hypoacusis, headaches in helmet and an alteration of the state. general. There was no notion of cough, evening fever or epistaxis. These symptoms motivated several unspecified treatments without improvement. Before the onset of ptosis and ipsilateral blindness, he consulted us for support. We noted on otoscopy a dull right eardrum with a hearing loss of 25 decibels (db). Ophthalmological examination showed ptosis, ophthalmoplegia and blindness on the right side. Nasofibroscopy revealed a budding lesion taking up the entire right half of the roof of the nasopharynx filling the Rosenmüller fossa. There was no palpable cervical adenopathy. HIV serology was negative. Maxillofacial computed tomography revealed a rectilinear nasal sinus osteolytic expansive tumoral process extending to the optic nerve as well as to the oculomotor muscles with grade II proptosis (figure 1). Two repeated biopsies of the lesion found tuberculosis in front of a gigantocellular epithelioid granuloma with caseous necrosis. Intradermal tuberculin reaction and AFB sputum became negative. The chest X-ray was normal. We carried out the surgical excision of the lesion and the diagnosis of tuberculosis was confirmed by the anatomopathological examination. The patient was placed under anti-tuberculosis verification according to the 2RHZE / 4RH Protocol. The evolution was favorable after two months with normalization of the signs on nasofibroscopy.

A comparative study to evaluate the effects of intranasal steroid spray, isotonic saline nasal irrigation and combination therapy in patients with allergic rhinitis

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Allergic rhinitis (AR) is characterized by inflammatory changes in the nasal mucosa caused by exposure to inhaled allergens. AR clinically having 2 or more symptoms of anterior or posterior rhinorrhea, sneezing, nasal blockage or itching of the nose during two or more consecutive days for more than 1 hour on most days which are caused by allergen exposure leading to an IgE mediated reaction. Nasal steroids and antihistamines are considered as gold standard treatment of choice in moderate to severe AR. This study was taken to evaluate the efficacy of intranasal steroid spray, isotonic saline nasal irrigation, combination therapy and to compare all 3 treatment modalities.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 75 patients of AR who met inclusion criteria were sequentially divided into 3 groups. Group A was intranasal steroid spray, group B was isotonic saline nasal irrigation, group C was combination of both intranasal steroid spray and saline nasal irrigation. Total nasal symptoms score was compared before and after 1 month of treatment.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Mean total nasal symptoms score before treatment in groups A, B and C was found to be 13.72, 12.96 and 13.68 respectively and after 1 month of treatment total nasal symptoms score was seen 8.28, 8.76 and 3.72 respectively.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The combined use of saline nasal irrigation along with intranasal corticosteroids is found to be more effective in reducing the symptoms of patients with allergic rhinitis when compared to individual therapies.&lt;/p&gt;

Endoscopic versus conventional septoplasty in the treatment of obstructive nasal septal deviation

Abstract BACKGROUND. Nasal septum deviations are disorders in which the nasal septum has an abnormal conformation that affects nasal breathing. Surgical correction of the deviated nasal septum, performed by various techniques, is one of the methods of repermeabilization of the upper airway. The aim of the present study was to evaluate the efficacy of endoscopic surgical treatment of the nasal septum deviation on the nasal obstruction, as well as to evaluate the frequency of postoperative complications compared to classical septoplasty. MATERIAL AND METHODS. A retrospective longitudinal study was performed on a group of 92 patients diagnosed with nasal septal deviation, between 2014-2018. 32 patients were excluded from the study after the exclusion criteria were applied. Two groups of 30 patients each were formed: Group I, endoscopic septoplasty was performed; Group II, the conventional septoplasty was used. An objective endoscopic and rhinomanometric evaluation, as well as a subjective assessment of symptoms (nasal obstruction, headache, posterior rhinorrhea, sneezing), was performed preoperatively and at 3 months postoperatively. RESULTS. The study showed better results (p&lt;0.05) and fewer complications in endoscopic septoplasty compared to the traditional one, the endoscopic septoplasty providing better lighting and improved access, allowing a limited incision. CONCLUSION. Endoscopic septoplasty can be considered a reliable alternative to traditional techniques. It is essential to correctly identify the type of preoperative deformity in order to select the appropriate surgical strategy.

An open-label, multicentre, randomized comparative study of efficacy, safety and tolerability of the 5 plant - extract BNO 1012 in the Delayed Antibiotic Prescription Method in children, aged 6 to 11 years with acute viral and post-viral rhinosinusitis

292 children aged 6 to 11 years with ARS were randomized in the multicenter, comparative study. They received an extract of five medicinal plants in addition to standard symptomatic therapy or standard therapy only. EVALUATION CRITERIA: reduction of the sinusitis severity according to a 4-point medical assessment scale (nasal congestion, severity of anterior and posterior rhinorrhea) at each visit, dynamics of self-scoring of rhinorrhea and headache (according to a 10-point visual analogue scale), "therapeutic benefit" in days, frequency of antibiotic prescriptions due to the use of an extract of five plants. The use of the 5-plant extract BNO 1012 in addition to the standard symptomatic treatment of acute rhinosinusitis provides a clinically significant, adequate reduction in the severity of rhinorrhea, nasal congestion and post-nasal drip, assessed by a physician at V2 (p < 0.005). Significant differences are noted in the patient's self-scoring of rhinorrhea on the second or third day in viral RS, and from the fourth to the eighth day in post-viral RS. Symptoms of similar intensity in control group were observed at V3. Thus, in the first week of treatment, the treatment group compared to the control one showed a "therapeutic benefit" of three days. The use of BNO 1012 in patients with acute rhinosinusitis can 1.81-fold reduce the prescription of antibacterial drugs. The combination of five medicinal plants is effective for the treatment of acute rhinosinusitis in children aged 6 to 11 years. Its use provides a significant "therapeutic benefit" when administered in addition to standard symptomatic therapy, reducing the need for antibiotic use.

Occupational Rhinitis: Classification, Diagnosis, and Therapeutics.

Occupational rhinitis (OR), an inflammatory disease of the nose, refers to any nasal symptoms reported to be work-related. The purpose of this review is to provide a current overview of the classification, diagnosis, and treatment of OR. Occupational rhinitis (OR) can further beclassified into allergic or non-allergic depending on the causative agent(s) and pathogenesis. Presenting symptoms are similar to non-OR including nasal congestion, anterior and posterior rhinorrhea, sneezing, and nasal itching. Despite its high prevalence in a spectrum of workplaces, OR is under reported as it is often considered a nuisance rather than a potential precursor to occupational asthma (OA). The diagnosis of OR is obfuscated as it is difficult to determine if this condition was caused by environmental determinants in or outside the workplace. Furthermore, workers may have a pre-existing history of allergic or non-allergic rhinitis leading theclinician and worker to overlook inciting agents in the workplace. In this case, a diagnosis ofOR is still possible depending on the exposures but must be differentiated from work-exacerbated rhinitis. Further complicating the diagnosis of OR is the lack of evidence-based research focused on this condition as it is often trivialized due to the perception that it has an insignificant impact on the worker's health. The reality is that OR can have a significant impact on the worker's quality of life and is associated with a number of comorbidities including occupationalasthma, recurrent sinusitis, headaches, eustachian tube dysfunction, and sleep disorders similar to non-occupational rhinitis. However, one significant difference between these disorders is that workers diagnosed with OR are eligible for worker's compensation. Treatment of OR involves avoidance of the inciting agent(s) and medications similar to those used to treat non-OR conditions. This review summarizes recent progresses on the etiology, risk factors, diagnosis, and therapy of OR. In addition, suggested areas of further research with potential targets for modifications in the workplace environment as well as therapeutic interventions will be discussed.

Efficacy and safety of herbal steam bath in allergic rhinitis: a randomized controlled trial

BackgroundAllergic rhinitis is a nasal mucosa inflammatory disorder that is induced by exposure to an allergen which results in four major symptoms, including anterior or posterior rhinorrhea, sneezing, nasal itching and nasal congestion. Allergic rhinitis may result in sleep disturbance, fatigue, depression of mood-cognitive function and quality of life impairment. ObjectiveThis study examined the efficacy and safety of herbal steam bath used for the reduction of allergic rhinitis symptoms, and evaluated treatment satisfaction and improvements in quality of life among participating patients with allergic rhinitis. Design, setting, participants and interventionA single-blind randomized controlled trial was conducted at Thai Traditional and Alternative Medicine Hospital between June and December 2016, using 64 subjects, equally divided into two groups. The treatment group received herbal steam bath and the control group received steam bath without herbs for 30 min 3 times a week for 4 consecutive weeks. Main outcome measuresAllergic rhinitis symptoms, such as itchy nose, runny nose, sneezing, nasal congestion and watery eyes, were measured using the visual analog scale at weeks 0, 1, 2, 3 and 4. Quality of life was assessed at week 0 and week 4. ResultsThe characteristics (sex, age, marital status, education, allergic rhinitis symptoms and frequency of symptoms) at the baseline were not statistically different (P > 0.05) between the two test groups. Anterior or posterior rhinorrhea symptoms, including sneezing, nasal itching and nasal congestion, were statistically reduced over the course of the treatment, but reductions were not significantly different between the control and treatment groups. The treatment group, however, was shown to be significantly more satisfied with the treatment than the control group (P < 0.05). ConclusionBoth treatments appear to be able to significantly reduce the symptoms of allergic rhinitis. However, there was no difference in the effectiveness of steam bath with herbs and steam bath without herbs. Trial registrationThis trial was registered in the Thai Clinical Trial Registry with the identifier TCTR20170712002.

Sinonasal symptom assessment by the self-reported DyNaChron questionnaire: Before or after consultation?

ObjectiveAssessment of sinonasal symptoms on a self-reported questionnaire is thoroughly subjective, but indispensable for quantifying symptoms. The present study sought to compare responses on the DyNaChron questionnaire just before and just after consultation for chronic sinonasal dysfunction. Materials and methods78 patients (mean age, 43.1±16.9 years) consulting for chronic sinonasal dysfunction took part in a prospective study, responding to the computerized version of the DyNaChron self-reported questionnaire, in a dedicated room, just before and just after medical interview and physical examination. ResultsMost patients tended to grade symptoms as less severe after consultation. Significant differences in mean score were found for nasal obstruction (difference of 0.94/10), anterior (0.40) and posterior rhinorrhea (0.26), olfactory disorder (0.65), and facial pain and headache (0.65), but not for chronic cough. ConclusionSelf-reported scores for chronic sinonasal dysfunction differ slightly from before to after consultation. They are therefore to be interpreted with caution, taking account of possible factors of bias.

Chronic Rhinosinusitis with Nasal Polyps

Chronic rhinosinusitis with nasal polyps (CRSwNP) is an important clinical entity diagnosed by the presence of both subjective and objective evidence of chronic sinonasal inflammation. Symptoms include anterior or posterior rhinorrhea, nasal congestion, hyposmia, and/or facial pressure or pain that last for a duration of more than 12 weeks. Nasal polyps are inflammatory lesions that project into the nasal airway, are typically bilateral, and originate from the ethmoid sinus. Males are more likely to be affected than females, but no specific genetic or environmental factors have been strongly linked to the development of this disorder to date. CRSwNP is frequently associated with asthma and allergic rhinitis, but the cellular and molecular mechanisms that contribute to the clinical symptoms are not fully understood. Defects in the sinonasal epithelial cell barrier, increased exposure to pathogenic and colonized bacteria, and dysregulation of the host immune system are all thought to play prominent roles in disease pathogenesis. Additional studies are needed to further explore the clinical and pathophysiological features of CRSwNP so that biomarkers can be identified and novel advances can be made to improve the treatment and management of this disease.

A Study on Epidemiological Chronic Sinusitis in Brazil

Introduction: Rhinosinusitis (RS) is in one of the most prevalent diseases of the upper airways, having high prevalence in Brazil, especially in children and its main viral etiology. Acute RS is infectious by nature, while chronic is considered multifactorial, involving the environment and associated diseases such as reflux and asthma. The most common symptoms are nasal obstruction, anterior or posterior rhinorrhea, facial pain or pressure, and reduction or loss of smell. When they last for more than 12 weeks, RS is chronic.

Multiple chemical sensitivity worsens quality of life and cognitive and sensorial features of sense of smell

Multiple chemical sensitivity (MCS) is characterized by a loss of tolerance to a variety of environmental chemicals. Multiple chemical sensitivity is frequently triggered by exposure to chemical agents, especially insecticides. The aim of the study was to measure the sense of smell and quality of life in patients with MCS compared to the control group. We studied the sense of smell, both sensitive and sensorial characteristics, in female patients with MCS (n = 58, mean 50.5 ± 8.5 years) and healthy female volunteers without rhinosinusal pathologies (n = 60, mean age 46 ± 10.2 years). Olfactometry (Barcelona Smell Test 24/BAST-24), sinonasal symptoms (visual analogue scale/VAS 0-100 mm), and quality of life (Quick Environmental Exposure and Sensitivity Inventory/QEESI) were assessed. Multiple chemical sensitivity patients showed a significant impairment in smell identification (19 ± 12 %; p > 0.05) and forced choice (62 ± 18 %; p > 0.05), but not in smell detection (96 ± 4 %) compared to the control group. Multiple chemical sensitivity patients reported more odours as being intense and irritating and less fresh and pleasant when compared with the control group. Patients scored a high level (40-100) on QEESI questionnaire (symptom severity, chemical intolerances, other intolerances, life impact). In MCS patients, total symptom intensity (VAS/0-700 mm) score was 202 ± 135, while disease severity score was 80 ± 23. The most frequent symptoms were itching and posterior rhinorrhea. Multiple chemical sensitivity patients have an impairment in smell cognitive abilities (odour identification and forced choice, but not for detection) with increased smell hypersensitivity and poor quality of life.