Olfactory, Function After Fess In Patient With Chronic Rhinosinusitis

This study was done to evaluate the olfactory function after FESS in patients with rhinosinusitis.This study was carried out in 40 patients suffering from distorted olfactory disability due to chronic rhinosinusitis. The patients were selected from the ENT Clinic of Zagazig University Hospitals in period from November 2005 to May 2006.All patients were submitted for full history taking (including personal history, complaints, history of present illness, past history and family history) and examination (including general and nasal examination by rigid endoscope).Olfaction was evaluated by simple olfactory screening test and identification test and also radiological examination [including Computed Tomography of Paranasal Sinuses (CT PNS)].Then, the patients underwent functional endoscopic sinus surgery using the rigid endoscope under general anesthesia with hypotensive technique.The main presentation of patients in this study was distorted olfactory disability and other presentations of chronic rhinosinusitis including nasal obstruction, nasal discharge and headache.The mean duration of the operation reported in this study was 55 minutes.Olfaction was completely improved postoperatively in 36 cases, mildly improved in 2 cases and anosmia in 2 cases; one of them is mildly improved after 2 weeks of operation by medical treatment in the form of steroids.Complications reported in this study included epistaxis in 2 cases, managed by nasal packs for 48 hours, one case of adhesion is between septum and middle turbinate, 2 cases of adhesions are between middle turbinate and lateral nasal wall.Olfaction is a complex process affected by chronic rhinosinusitis in ways yet to be shown. Most likely, it is a combination of factors including physical blockade to airflow, neuroepithelial edema, and direct neurotoxic affects of viruses and bacterial toxins. An individual’s qualitative sense of smell is also affected by that individual’s personal experience and overall state of physical and mental health. Patients often ask the likelihood of subjective improvement in olfaction after endoscopic sinus surgery. Based on our data, patients can be expected to improve significantly in a period up to one year after surgery. This most likely represents a combination of surgery and postoperative medical therapy.