Olfaction and sinonasal symptoms in patients with CRSwNP and AERD and without AERD: a cross-sectional and longitudinal study

Oral aspirin challenge (OAC) reveals aspirin-exacerbated respiratory disease (AERD) in approximately 50% of unselected patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). Smell loss is one factor that predicts the outcome of OAC. The present study aims to unveil differences in olfactory function between patients with CRSwNP with and without AERD by means of a validated reliable test for odor threshold, discrimination and identification. Additionally, Beck Depression Inventory (BDI) and Sinonasal Outcome Test 22 (SNOT 22) were applied. 31 patients were tested before and 7 months after OAC and aspirin desensitization in case of diagnosed AERD. AERD was diagnosed in 16 and excluded in 15 patients. Patients with AERD demonstrated significantly more olfactory loss, but no difference in BDI or SNOT 22 at baseline. Olfaction of the groups equalized at follow-up. Sinonasal complaints decreased significantly in patients with AERD, but not in the group without AERD. Olfactory loss is a valuable marker for AERD, but due to the variance of olfactory test results prediction of AERD by exclusively any of the applied olfactory tests appears unreliable.