Work

Predictive value of eosinophil-to-lymphocyte ratio combined with computed tomography scores for olfactory recovery in chronic rhinosinusitis with nasal polyps

Year: 2025

Type: article

Abstract: BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a debilitating inflammatory disease often complicated by olfactory dysfunction. Despite surgery being a primary treatment, predicting postoperative olfactory recovery remains challenging. Eosinophilic inflammation and sinus computed tomography (CT) characteristics may serve as prognostic markers, yet their combined utility in predicting olfactory dysfunction outcomes is underexplored. OBJECTIVE: To investigate the predictive effect of eosinophil-to-lymphocyte ratio (ELR) from peripheral blood tests, combined with ethmoid sinus-to-maxillary sinus (E/M) ratio, and ethmoid sinus score minus maxillary sinus score (E-M) on olfactory recovery in patients with CRSwNP. METHODS: This single-center, retrospective cohort study was conducted from January 2022 to June 2024. A total of 137 patients with CRSwNP and 52 healthy controls were included. Preoperative and postoperative olfactory functions were assessed using the Sniffin' Sticks test. ELR, E/M ratio, and E-M score were calculated based on blood tests and CT scans. Logistic regression analysis and receiver operating characteristic curve analysis were used to identify and validate predictive factors for olfactory recovery. RESULTS: The median preoperative threshold-discrimination-identification score was 10 (IQR 7-24), improving to 26 (IQR 15-33) at 6 months postoperatively, with a median improvement (change in threshold-discrimination-identification) of 7 (IQR 2-14). ELR, E/M ratio, and E-M score were significantly higher in patients with poor olfactory recovery (all P < .05). Logistic regression analysis revealed that ELR (model 1: odds ratio [OR] = 1.199; model 2: OR = 1.209), E/M ratio (OR = 3.236), and E-M score (OR = 2.179) were independent risk factors for poor olfactory prognosis. Receiver operating characteristic curve analysis revealed that the combined index demonstrated superior predictive performance. CONCLUSION: A composite model integrating ELR with CT-based E/M ratio or E-M score effectively predicts olfactory recovery in patients with CRSwNP. These accessible biomarkers aid in stratifying patients for personalized treatment and postoperative monitoring. TRIAL REGISTRATION: ChiCTR2100047644.

Source: Annals of Allergy Asthma & Immunology

DOI: 10.1016/j.anai.2025.10.009