RHINOLOGY Comparison of the effect of endoscopic sinus surgery versus medical therapy on olfaction in nasal polyposis Mohammad Hossein Baradaranfar • Zeynab Sadat Ahmadi • Mohammad Hossein Dadgarnia • Mohammad Hossein Bemanian • Saeid Atighechi • Ghasem Karimi • Abolhasan Halvani • Nasim Behniafard • Amin Baradaranfar • Tohid Emami Meybodi Received: 31 January 2013 / Accepted: 3 May 2013 / Published online: 23 May 2013 Ó Springer-Verlag Berlin Heidelberg 2013 Abstract Chronic rhinosinusitis is a common inflamma- tory condition in western countries. Nasal polyposis has different symptoms such as nasal obstruction, anterior or posterior nasal drip, reduced sense of smell, and facial pain. Medical and endoscopic treatments are the two main treatments for nasal polyposis. Our aim was to compare the efficacy of different methods on olfactory function. This is a non-randomized clinical trial study that was done on 60 patients who were divided into two groups (medical and surgical). Patients were matched based on age, history of smoking, and the severity of obstruction. The radiologist score of Lund-Mackay staging system was used to match patients in two arms of the trial based on the severity of nasal obstruction. Patients in surgery groups underwent functional endoscopic sinus surgery under general anes- thesia and then received Fluticasone propionate nasal spray for 8 weeks (400 mcg bd). Patients in the medical group were only prescribed with Fluticasone propionate with the same duration and same dose as mentioned. As a result of treatment protocol, both medical and surgical group experienced improvement in olfactory function but statis- tical analyses revealed that surgery resulted in better res- olution of symptoms. Our observation revealed that combined treatment had a better effect than medical treatment in restoring olfaction in patients with nasal polyposis. Keywords Endoscopic sinus surgery Á Medical therapy Á Olfaction Á Nasal polyposis Á Non-randomized clinical trial Introduction Chronic rhinosinusitis is a common inflammatory condition in western countries. It is reported that this disorder affects nearly 2–4 % of the population [1, 2]. Nasal polyposis can negatively influence the quality of life [3] and have dif- ferent symptoms such as nasal obstruction, anterior or posterior nasal drip, reduced sense of smell, and facial pain [4]. The underlying cause for developing nasal polyposis is unclear but it is thought that different factors including genetics, allergic, and inflammatory factors are responsible [5, 6]. Steroids play an important role in the management of nasal polyposis. Topical and systemic steroids are widely used to resolve or diminish symptoms [7]. If medical treatment failed, the second choice of treatment is M. H. Baradaranfar (&) Á Z. S. Ahmadi Á M. H. Dadgarnia Á S. Atighechi Á G. Karimi Department of Otolaryngology, Head and Neck Surgery, Rhinology Research Center, Shahid Sadoughi University of Medical Science and Health Services, Yazd, Iran e-mail: rhinology_research@ssu.ac.ir; baradaranf@yahoo.com M. H. Bemanian Department of Immunology, Asthma and Allergy, Children’s Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran A. Halvani Department of Pulmonary Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran N. Behniafard Rhinology Research Center, Shahid Sadoughi University of Medical Science and Health Services, Yazd, Iran A. Baradaranfar Tehran University of Medical Sciences and Health Services, Tehran, Iran T. E. Meybodi School of Medicine, Shahid Sadoughi University of Medical Science and Health Services, Yazd, Iran 123 Eur Arch Otorhinolaryngol (2014) 271:311–316 DOI 10.1007/s00405-013-2553-6