Smell disorders and their associated factors among adult patients with chronic rhinosinusitis in Mulago National Referral Hospital

Abstract

Background A smell disorder is the alteration in the perception of odours. Among patients with chronic rhinosinusitis, smell disorders are very common with an approximate prevalence of 30-78%. This loss of smell has significant effect on the quality of life of these patients including enjoyment of food and the environment. Anxiety and depression have also been linked to these smell disorders. These patients are also vulnerable to environmental hazards such as fires, gas leaks and stale foods as they cannot detect them. The aim of this study was to determine the prevalence, the types, the degrees of loss of smell, and the associated factors among adult patients with chronic rhinosinusisits attending ENT clinic, Mulago National Referral Hospital. Methodology This was a cross-sectional study in a tertiary center, Mulago National Referral Hospital, Kampala, Uganda. The study subjects were patients who had chronic rhinosinusitis attending the ENT clinic. A nasal endoscopic examination was used to confirm chronic rhinosinusitis. In this study, patients with a history of head injury, brain surgery, sinonasal malignancies, psychiatric or on antipsychotics or those who were too sick to participate were excluded. A consecutive sampling technique was used and 90 participants were recruited. The smell disorders were evaluated using the Sniffin`Sticks test. A total score (TDI score) which is a summation of the three components, was used to grade the severity of loss of smell. The association between patient factors and loss of smell was done in bivariate and multivariate analysis. Results The prevalence of smell disorders among adult patients with chronic rhinosinusitis in MNRH using the Sniffin sticks test (TDI sore) was 64.4%. The types of smell disorders were conductive smell disorder at 42.2%, sensorineural smell disorder at 22.2%. The degrees of smell disorders were anosmia at 15.6%, hyposmia at 48.9%. The factors that were found to be associated with smell disorders were age (p-value < 0.001 OR 5.66 CI (95%) 2.24-14.30), nasal polyps, (aPR-2.52, 95%CI (1.75-3.62) and p-value <0.001), a high Lund Mackay score [aPR-0.96, 95%CI (0.92-0.10) and p-value <0.047)]. Conclusion The prevalence of smell disorders is this study was high (64.4%). At 42.2%, the conductive smell disorders were the most prevalent. Nearly half of this study cohort had hyposmia at 48.9%. The factors that were found to be associated with smell disorders in this study were: increasing age, nasal polyposis, and high Lund-Mackay score on CT scan.