Author(s)
Tran B. Le, MD
Vidur Bhalla, MD
Jennifer A. Villwock, MD
David D. Beahm, MD
Alexander G. Chiu, MD, FARS
Affiliation(s)
University of Kansas Medical Center
Abstract:
Introduction: Certain patterns of nasal polyposis have been associated with varying comorbidities, histology, disability, and radiographic imaging. Central nasal polyposis (CNP), polyposis of the olfactory cleft, is an understudied area, and this study seeks to describe its associated findings. Methods: A retrospective cohort study was performed evaluating all patients who underwent endoscopic sinus surgery (ESS) in 2016 at a tertiary care center. Patients’ computed tomography scans were evaluated for olfactory cleft opacification (OCP), which were graded 0-4, and Lund-MacKay (LM) scores were calculated. Charts were reviewed for demographic information, polyposis, comorbidities, previous surgeries, need for revision ESS, and complaints of olfactory dysfunction. Results: 154 patients had ESS performed at our institution, of which 67 (43.5%) of patients had OCP. There was no significant difference in age between groups (p=0.539), but the OCP group was chiefly male (34.5% vs 64.2%, p=0.025). OCP patients compared to non-OCP patients were more likely to have aspirin exacerbated respiratory disease (7.5% vs 1.1%, p=0.045), greater number of surgeries (1.12 vs 0.62, p=0.031), higher LM scores (14.1 vs 5.8, p<0.001), have nasal polyposis (73.1% vs 27.6%), and have hyposmia (49.3% vs 25.3%, p=0.002). There was no significant difference in presence of asthma (p=0.077) and need for revision ESS (p=0.171). Patients with higher OCP scores were significantly more likely to have asthma, AERD, hyposmia, higher LM scores, and nasal polyposis (p<0.05). Discussion: CNP patients have greater comorbidities, olfactory dysfunction, and disease burden than their non-CNP counterparts. Further studies evaluating its prognostic factors and immunogenic etiologies are needed.