Patients with chronic rhinosinusitis (CRS) with nasal polyps exhibited significant improvement in olfactory function when treated with a combination of oral and nasal steroids vs nasal steroids alone.
Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) exhibited significant improvement in olfactory function when treated with a combination treatment of oral and nasal steroids vs nasal steroids alone after 24 weeks. Results were published in European Annals of Otorhinolaryngology, Head and Neck Diseases.
Cited by patients with CRSwNP as the most prominent symptom they wish to restore, olfactory dysfunction is estimated to occur in 60% to 80% of those with the condition. Despite the availability of several interventions in the management of CRSwNP, researchers note that there is no consensus regarding the optimal medical approach to ensure adequate and long-term disease control for patients with smell impairment as the dominant symptom.
“Olfactory impairment is caused by mucosal inflammation, as well as mechanical obstruction of the olfactory cleft by polyps,” explained the study authors. “Medical treatment options for nasal polyps include topical and systemic steroids, short and long-term antibiotics, and additional care with antihistamines, antileukotrienes, antimycotics, capsaicin, and nasal douching.”
With several trials showing a positive effect of oral steroids on olfactory outcomes in patients with CRSwNP, they sought to explore the effects of oral dexamethasone plus intranasal steroids (INCS) vs INCS alone.
In the prospective randomized nonblinded study, patients with CRSwNP experiencing hyposmia (N = 140; 53.4% men) were recruited from the Outpatient Clinic and the Allergy and Endoscopy Clinic of the Otorhinolaryngology Department of Chania General Hospital in Greece.
Participants were divided into 2 groups, in which group A (n = 20) received a 7-day course of oral steroids with a 12-week course of nasal steroids and douching, and group B (n = 70) received a 12-week course of nasal steroids and douching.
The main objective of the study was to compare the olfactory effect of the different therapies in group A and group B at 2, 12, and 24 weeks, measured via Sniffin’ Sticks identification test and visual analogue scale score for olfaction (VASsmell). Several secondary objectives were also explored:
After 2 weeks, a statistically significant difference was observed between groups A and B for all parameters except VASdis (P < .001). Moreover, olfactory outcomes (Sniffin’ Sticks and VASsmell scale scores) were significantly improved in group A vs group B at the 24-week evaluation (P < .001).
Regarding effect duration within the groups, the therapeutic result remained stable between the 12-week and 24-week evaluations (P > .05). The Sniffin’ Sticks identification test score further showed a signficant correlation at the 12-week evaluation with the endoscopic appearance score system (rho = 0.58; P < .001), but not with SNOT22-Gr (rho = 0.3; P = .012).
“According to our exclusion criteria, in carefully selected and strictly instructed patients with CRSwNP, a low-dose 7-day course of oral dexamethasone may achieve a favorable outcome regarding olfaction and health-related quality of life for at least half a year,” concluded the study authors.
Reference
Papadakis CE, Chimona TS, Chaidas K, Ladias A, Zisoglou M, Proimos EK. Effect of oral steroids on olfactory function in chronic rhinosinusitis with nasal polyps. Eur Ann Otorhinolaryngol Head Neck Dis. 2021;138(5):343-348. doi:10.1016/j.anorl.2020.06.028
ICS Use Tied to Fewer Exacerbations in Patients With Bronchiectasis and Elevated Blood Eosinophils
June 6th 2025Inhaled corticosteroid (ICS) use was common among patients with bronchiectasis and was associated with reduced exacerbations and hospitalizations in those with elevated blood eosinophil counts.
Read More
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
Listen
At EHA 2025, Hematology Discussions Will Stretch Across Lifespans and Locations
June 5th 2025The 2025 European Hematology Association (EHA) Congress, convening virtually and in Milan, Italy, from June 12 to June 15, 2025, will feature a revamped program structure for the meeting’s 30th anniversary while maintaining ample opportunities to network, debate, and absorb practice-changing findings in hematology and oncology.
Read More