Smoking-Induced Olfactory Dysfunction in Chronic Sinusitis and Assessment of Brief University of Pennsylvania Smell Identification Test and T&T Methods

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Abstract
Background: To evaluate the outcome of smell activity after endoscopic sinus surgery in chronic sinusitis, it is important to verify evidence of smoking-induced olfactory dysfunction. Methods: In both the preoperative and the postoperative stages, the 5-odorant T&T olfactometer (T&T5) and the 40-item University of Pennsylvania Smell Identification Test (UPSIT40) were administered to 100 patients (84 men and 16 women; mean age, 49.5 years; range, 21–75 years) who underwent surgery for chronic sinusitis. Additionally, as more simplified measures, we adopted a 3-odorant T&T (T&T3) and a 12-item UPSIT (UPSIT12), and then compared findings with those of each original method. Results: (1) Obvious correlations of scores were noticed both between T&T5 and T&T3 and between UPSIT40 and UPSIT12 (r = 0.964 and 0.893, respectively), (2) significant changes in postoperative scores were observed on all four measurements (p < 0.0001), (3) smoking-induced hyposmia was noticeable in older subjects but not in younger subjects, and (4) the correlations of postoperative scores and the age of smoker or the smoking dose was significant (UPSIT40, r = 0.825 or 0.642; UPSIT12, r = 0.666 or 0.428; T&T5, r = 0.447 or 0.476; T&T3, r = 0.457 or 0.500, respectively). Conclusion: The abbreviated measures of T&T3 and UPSIT12 could be available enough to assess the effect of surgical intervention on olfaction, while the original UPSIT40 was considered to be the most sensitive among the four methods tested here for examining the impact of smoking on olfaction.