Olfaction and Nasal Polyposis

Smell plays an important role in the quality of life. Olfactory dysfunction is most commonly caused by nasal polyposis (NP). Smell is a sense that is all too often forgotten and may escape the notice of both surgeons and patients. Optimizing the medical treatment of mucosal disease is important in providing symptomatic relief either on its own or in conjunction with surgery. Routine preoperative smell testing is advisable in assessing patients prior to surgery. Subjective test methods are frequently used to assess olfaction because they can be done quickly and easily in a compliant patient—e.g., screening tests of olfaction. The exact size of the olfactory neuroepithelium in humans is still not well established. Olfactory function correlates with disease severity. Far less or no surgery is needed if medical treatment has been successful. In severe olfactory loss with CRS and NP, the objective measures of olfaction generally improve significantly after endoscopic sinus surgery, particularly if the olfactory cleft is widened. Impairment of smell may be the first sign of a recurrence of nasal disease and helps to motivate the patient to accept long-term medical treatment.