The following is a summary of “Surgical and medical management of chronic rhinosinusitis in pediatric cystic fibrosis patients: Impact on olfactory symptoms,” published in the February 2024 issue of Pediatrics by Shan et al.

Olfactory dysfunction (OD) is a common issue in individuals with sinonasal dysfunction, yet its prevalence and severity in adolescents with cystic fibrosis (AwCF) remain unclear. Given the potential impact of OD on dietary intake and nutritional status, there is a need to assess the effectiveness of both medical and surgical interventions for sinonasal symptoms in this population and their implications for olfactory function.

The researchers conducted a comprehensive literature search spanning from 1980 to 2022 using PubMed, Embase, Web of Science, and Ebsco CINAHL, following PRISMA-ScR guidelines, to conduct a scoping review. Data on study design, patient demographics, clinical characteristics, outcomes, and risk of bias were extracted.

Out of 368 abstracts, three articles exclusively focused on AwCF, totaling 34 patients. Among these, two studies evaluated endoscopic sinus surgery (ESS) and dornase alfa. Additionally, six articles including mixed pediatric and adult CF populations (totaling 313 patients) were included. Interventions encompassed ESS, elexacaftor-tezacaftor-ivacaftor (ETI), ivacaftor, saline, dornase alfa, hyaluronic acid, and hyaluronic acid-tobramycin combination. Outcome measures varied, including subjective assessment of OD using both non-validated (4/9) and validated (4/9) surveys, as well as psychophysical smell testing (1/9). Studies evaluating ESS, functional endoscopic sinus surgery (FESS), dornase alfa, ivacaftor, and hypertonic/isotonic saline reported statistically significant improvement in OD. However, ETI did not demonstrate improvement in OD despite enhancing other quality-of-life measures.

Limited data are available regarding the impact of medical and surgical interventions on olfaction in AwCF. Moreover, assessment of olfactory outcomes often relies on subjective and qualitative self-reports, highlighting the necessity for psychophysical testing in this population with dietary challenges and weight management issues.

Source: sciencedirect.com/science/article/abs/pii/S0165587624000521