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

Abstract

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. 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. 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. 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. NCT04469439.