Olfactory cleft evaluation: a predictor for olfactory function in smell-impaired patients?

Abstract

Objective

In this study, we introduce an extension of previous work by Soler et al. (Int Forum Allergy Rhinol 6(3):293–298, 2016) on a modified endoscopic scoring system of the Lund–Kennedy Score (focusing on the olfactory cleft) to evaluate its correlation with the olfactory function in patients with various smell disorders.

Study design

A prospective cohort study.

Methods

Two-hundred and eighty-eight participants were included and categorized in five groups according to the cause of their olfactory disorder: (0) control, (1) idiopathic, (2) sino-nasal, (3) postinfectious and (4) post traumatic olfactory loss. Olfaction was evaluated using the "Sniffin' Sticks" test. The classical Lund–Kennedy scoring and a new olfactory cleft specific Lund–Kennedy scoring (OC–LK) were performed to evaluate mucosal changes.

Results

Significantly higher OC–LK scores on both sides were found in smell-impaired patients as compared to normosmic controls. When comparing the 4 groups, a significant difference of the OC–LK score were present between the sino-nasal and all other groups. Most importantly, significant negative correlations with strong effects were shown in the sino-nasal group between the OC–LK score and odor discrimination and odor identification. However, no such correlation emerged between the classical LK score and smell function.

Conclusion

Olfactory cleft evaluation using the OC–LK score correlates with the olfactory function in patients with sino-nasal smell disorder. This diagnostic tool may reflect the underlying pathophysiological mechanism of sino-nasal smell loss, and therefore, should complement olfactory diagnostics in patients with sino-nasal smell disorder.

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