Liufeiyan Fan, Zhong Zheng, Haofei Bai, Silyu Jing, Chunyang Zhang, Weijia Du, Yubin Lai, Min Xu, Jian Wang, Tao Xue, Fuquan Chen
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引用次数: 0
Abstract
Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a debilitating inflammatory disease often complicated by olfactory dysfunction (OD). Despite surgery being a primary treatment, predicting postoperative olfactory recovery remains challenging. Eosinophilic inflammation and sinus computed tomography (CT) characteristics may serve as prognostic markers, yet their combined utility in predicting OD outcomes is underexplored.
Objective: To investigate the predictive effect of eosinophil-to-lymphocyte ratio (ELR) from peripheral blood tests, combined with ethmoid sinus-to-maxillary sinus (E/M) ratio, and ethmoid sinus score minus maxillary sinus (E-M) score on olfactory recovery in CRSwNP patients.
Methods: This single-center, retrospective cohort study was conducted from January 2022 to June 2024. A total of 137 CRSwNP patients and 52 healthy controls were included. Preoperative and postoperative olfactory functions were assessed using the Sniffin' Sticks test. ELR, E/M ratio, and E-M score were calculated based on blood tests and CT scans. Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were used to identify and validate predictive factors for olfactory recovery.
Results: The median preoperative TDI score was 10 (IQR 7-24), improving to 26 (IQR 15-33) at 6 months postoperatively, with a median improvement (ΔTDI) of 7 (IQR 2-14). ELR, E/M ratio, and E-M score were significantly higher in patients with poor olfactory recovery (all p < 0.05). Logistic regression analysis showed that ELR (Model 1: OR = 1.199; Model 2: OR = 1.209), E/M ratio (OR = 3.236), and E-M score (OR = 2.179) were independent risk factors for poor olfactory prognosis. ROC curve analysis showed that the Combined Index showed superior predictive performance.
Conclusion: A composite model integrating ELR with CT-based E/M ratio or E-M score effectively predicts olfactory recovery in CRSwNP patients. These accessible biomarkers aid in stratifying patients for personalized treatment and postoperative monitoring.
期刊介绍：
Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.
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