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Validation of a Visual Analog Scale for Loss of Smell as a Quick Test in Chronic Rhinosinusitis With Nasal Polyps
Alobid I1,2,3*, Calvo-Henríquez C4,5*, Viveros-Díez P6, López-Chacón M1,2,3, Rojas-Lechuga MJ2,3,7, Langdon C1,2,3, Marin C2,3, Mullol J2,3,7
1Skull Base Unit, ENT Department, Hospital Clínic Barcelona, IDIBAPS, Barcelona University, Barcelona, Catalonia, Spain
2INGENIO, IRCE, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
3CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Spain
4Rhinology Unit, ENT Department, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
5Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Study Group
6ENT department, University Hospital of Valladolid, Valladolid, Spain
7Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
*These authors share first-author responsibilities.
J Investig Allergol Clin Immunol 2024; Vol 34(6)
: 377-384
doi: 10.18176/jiaci.0937
Background and Objective: The diagnostic criteria of chronic rhinosinusitis with nasal polyps (CRSwNP) include olfactory dysfunction. We hypothesize that patients with CRSwNP can self-assess their sense of smell better using a visual analog scale (VAS) than using smell tests.
Methods: A controlled cross-sectional study was performed. Adults diagnosed with severe CRSwNP waiting for endoscopic sinus surgery were included. A cohort of healthy controls was also studied. All participants completed the Barcelona Smell Test 24 (BAST-24), the 22-item Sinonasal Outcomes Test 22 (SNOT-22), and a VAS for loss of smell. Patients with CRSwNP underwent blood testing (eosinophil count, total serum IgE), computed tomography (Lund-Mackay Score), and nasal endoscopy.
Results: The study population comprised 138 patients with severe CRSwNP and 40 controls. The BAST-24 identification score was strongly correlated with the VAS score in the CRSwNP group (p=–0.79, P<.001) but not in the control group (p=–0.14; P=.39), this difference between groups being statistically significant (P<.001). A significant correlation was found between SNOT-22 item 21 (loss of smell) and BAST-24 identification (p=–0.65, P<.001), this difference being statistically significant (Z=–2.43; P=.015). The area under the receiver operating curve was 0.85, with 72.5% sensitivity and 93.1% specificity.
Conclusion: This study demonstrates a potential role of the VAS score for the screening of olfactory dysfunction in severe CRSwNP in daily clinical practice.
Key words: Polyposis, CRSwNP, Rhinosinusitis, BAST-24, Smell
