Presentation Details
| Incidence of smell loss in patients with allergic fungal rhinosinusitis: A single-center retrospective chart review Maria V.Villanueva, Fanchao Zhu, Jeb M.Justice, Brian C.Lobo, Nikita Chapurin, Jennifer K.Mulligan. Department of Otolaryngology-Head & Neck Surgery, University of Florida, Gainesville, FL, USA |
Abstract
Background: Allergic fungal rhinosinusitis (AFRS) is a distinct subtype of chronic rhinosinusitis with nasal polyps (CRSwNP), the leading cause of olfactory loss. Despite both having the presence of polyps, AFRS tend to present as a unilateral disease and occurs most frequently in younger males and African Americans. AFRS occurs almost exclusively in the southeastern US, due to the warmer, more humid climate which is optimal to fungal growth. Although smell loss is one of the cardinal symptoms of CRSwNP, it has not been described in AFRS patients, and thus the focus of these studies. Methods: Single-center, retrospective chart review of a total of 815 patients enrolled from February 2021 to December 2025 was conducted. Olfactory function was evaluated using the UPSIT. Subjective disease severity was measured by the validated SinoNasal Outcomes Test-22 questionnaire (SNOT22), Patients under 18 years of age or possible malingering results in their UPSIT were excluded. Results: AFRS patients have a statistically significant lower UPSIT scores when compared to control and CRSsNP. The degree of olfactory loss was equal to CRSwNP. More than 90% of AFRS patients experience some degree of olfactory loss, with 32.5% experiencing total anosmia. AFRS patients also had a significant worse SNOT22 score compared to control and CRS without polyps (CRSsNP) patients, showing worse subjective disease severity. Conclusion: Patients with AFRS has a similar degree of olfactory loss compared to patients with CRSwNP, and significantly worse than control and CRSsNP patients. This is particularly interesting given AFRS typically presents as unilateral disease while CRSwNP is bilateral. This suggests that inflammation, and not air flow obstruction, may be responsible for CRSwNP and AFRS-related olfactory loss.
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