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

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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. LEVEL OF EVIDENCE: 3: TRIAL REGISTRATION: NCT04469439.

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