Nasal obstruction and smell impairment in nasal polyp disease: correlation between objective and subjective parameters.

BACKGROUND: Chronic rhinosinusitis with nasal polyposis (NP) represents an invalidating disorder that causes mainly nasal blockage and loss of smell. The aim of this study is to investigate correlations between individual subjective and objective parameters of stable NP disease.

METHODS: 65 NP patients scored their sinonasal symptoms on a visual analogue scale (VAS) and questionnaires (SNOT-22 and SF-36). Peak nasal inspiratory flow (PNIF) measurement, Sniffinatm Sticks (SS) smell test, blood analysis for eosinophilia, total IgE and culture for Staphylococcus aureus (SA) were performed.

RESULTS: VAS scores for nasal blockage correlated with the SNOT-22 and SF-36 scores, which was not observed for VAS of other symptoms. VAS scores for nasal blockage correlated well with PNIF values as well as VAS scores for smell dysfunction and SS results (both p<0.001). NP size correlated with VAS scores for nasal blockage (p<0.01) but not with VAS for other symptoms. NP size showed an inverse correlation with PNIF and SS scores (both p<0.05). Blood eosinophilia correlated with subjective smell reduction (p<0.05). The presence of SA or total IgE levels were not associated with symptoms of NP disease.

CONCLUSION: PNIF and SS are good tools to evaluate symptoms of nasal obstruction and smell reduction in NP disease. Nasal blockage is the only symptom that correlates well with NP size and SNOT-22 scores, whereas smell reduction correlates with blood eosinophilia.