Effect of Combined Mycotic Infection on Postoperative Olfactory Dysfunction in Patients with Chronic Rhinosinusitis with Nasal Polyp Undergoing Endoscopic Surgery

LIU Nan; LI Yujie; YU Min; LI Ying

doi:10.3969/j.issn.1004-437X.2023.22.016

Abstract：Objective To investigate the effect of mycotic infection on postoperative olfactory dysfunction in patients with chronic rhinosinusitis with nasal polyp(CRSwNP)undergoing endoscopic surgery.Methods A total of 113 CRSwNP patients admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2021 to June 2022 were selected as the research subjects,and the nasal turbinate surface mucosa of the patients was taken for biopsy,and the mycotic infection was counted.All patients underwent endoscopic surgery,and the severity of olfactory dysfunction was tested using Sniffin's Stickers olfactory stick one month after surgery.The relationship between mycotic infection and postoperative olfactory dysfunction in CRSwNP patients was analyzed using point binary correlation,and the influencing factors of postoperative olfactory dysfunction in CRSwNP patients were analyzed using logistic regression.Results Through surface mucosal tissue section examination,it was found that 83 patients with CRSwNP had negative fungal tests,accounting for 73.45％,while 30 patients had positive fungal tests,accounting for 26.55％.Among them,20 were infected with Aspergillus,6 with Candida albicans,and 4 with Mucor.The olfactory dysfunction(TDI)score in the mycotic infection group was lower than that in the non mycotic infection group at 1 month after endoscopic surgery(P＜0.05).Among the mycotic infection group,11 patients(36.67％)developed olfactory dysfunction,which was higher than that of the non mycotic infection group[4 cases(4.82％)],and the difference was statistically significant(P＜0.05).There was no statistical significant difference in age,gender,body mass index(BMI),course of disease,smoking status,and alcohol consumption between the olfactory dysfunction group and the olfactory normal group(P＞0.05).The difference in clinical staging and Lund-Mackay score between the normal olfactory group and the olfactory dysfunction group was statistically significant(P＜0.05).Through point two column correlation analysis,the results showed a negative correlation between mycotic infection and postoperative TDI score in CRSwNP patients(r=-0.417,P＜0.001).Through logistic regression analysis,the results showed that mycotic infection and Lund-Mackay score were risk factors for postoperative olfactory dysfunction in CRSwNP patients after endoscopic surgery(OR＞1,P＜0.05).Conclusion The severity of olfactory dysfunction is more severe in CRSwNP patients with combined mycotic infections,and the combination of mycotic infection and high Lund-Mackay score are risk factors for postoperative olfactory dysfunction in CRSwNP patients undergoing endoscopic surgery.