Olfaction, Eating Preference, and Quality of Life in Cystic Fibrosis Chronic Rhinosinusitis.

Ashoke Khanwalkar, Michelle J Lee, Karolin Markarian, Todd E Bodner, Naweed I Chowdhury, Sei Y Chung, Patricia H Eshaghian, Yuqing A Gao, Anne E Getz, Jakob L Fischer, Douglas A Li, Meghan Norris, Cameran Owens, Lindsay E Pappas, Grant A Turner, Milene T Saavedra, Daniel M Beswick, Jonathan B Overdevest, Marilene B Wang, Jeffrey D Suh, Jess C Mace, Zachary M Soler, Jivianne T Lee, Timothy L Smith, Peter H Hwang, Zara M Patel, Adam J Kimple, Jeremiah A Alt, Jayakar V Nayak, Rodney J Schlosser, Kristine A Smith, Katie Poch, Jennifer L Taylor-Cousar, Christine M Liu

Journal: The Laryngoscope 2025;135(7):2476-2488

PMID: 40156369

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Abstract

OBJECTIVES

Olfactory dysfunction (OD) is common among people with cystic fibrosis (PwCF) and chronic rhinosinusitis (CRS). OD is associated with impaired quality of life (QOL) and dietary alterations in certain non-CF populations. This study explored relationships between OD, QOL, and modulator use in PwCF.

METHODS

This is a cross-sectional analysis of an ongoing multicenter, prospective study (2019-2023) investigating PwCF with comorbid CRS. Participants completed the 40-Question Smell Identification Test (SIT-40), 22-question SinoNasal Outcome Test-(SNOT-22), Questionnaire of Olfactory Disorders (QOD-NS), and Cystic Fibrosis Questionnaire-Revised (CFQ-R). Clinical and sinus CT data were collected. After stratification by SIT-40 score, data was analyzed by chi-square, Kruskal-Wallis, Spearman correlation, and logistic regression to identify factors associated with OD.

RESULTS

Of 59 participants, those with anosmia (n = 12) had worse eating-related QOL (CFQ-R eating) compared to individuals with normosmia (n = 16) and hyposmia (n = 31). Participants with anosmia had worse sinus CT scores than those with hyposmia. Although PwCF treated with highly effective modulator therapy (HEMT; n = 30) had better CT scores vs. non-HEMT individuals (n = 23), rates of OD in both groups were comparable. Higher SNOT-22 total scores were associated with increased odds of hyposmia or anosmia. In an eating-related QOD-NS subscore, those with worse CFQ-R eating had 2.38 times higher odds of having OD. Each point decrease in CFQ-R eating domain score was associated with 10% increased odds of OD.

CONCLUSION

In PwCF, OD was associated with increased CRS severity, impaired olfactory QOL, and decreased CFQ-R eating. There were no differences in SIT-40 or QOD-NS scores based on HEMT status.

TRIAL REGISTRATION

NCT04469439.

Address: Department of Head and Neck Surgery, University of California, Los Angeles, Los Angeles, California, USA.; Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland, Oregon, USA.; Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.; CTSI, David Geffen School of Medicine University of California, Los Angeles, Los Angeles, California, USA.; Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA.; Department of Psychology, Portland State University, Portland, Oregon, USA.; Department of Otolaryngology-Head and Neck Surgery, Vanderbilt Health, Nashville, Tennessee, USA.; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.; Department of Pulmonary Medicine, University of California, Los Angeles, Los Angeles, California, USA.; Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA.; Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alta, California, USA.; Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.; Department of Medicine, National Jewish Health, Denver, Colorado, USA.; Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.; Department of Medicine, National Jewish Health, Denver, Colorado, USA.; Department of Pediatrics, National Jewish Health, Denver, Colorado, USA.

DOI: 10.1002/lary.32155

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MeSH Terms: Adult, Female, Humans, Male, Middle Aged, Chronic Disease, Cross-Sectional Studies, Cystic Fibrosis, Food Preferences, Olfaction Disorders, Prospective Studies, Quality of Life, Rhinitis, Rhinosinusitis, Sinusitis, Smell, Surveys and Questionnaires