Abstract：
BACKGROUND: Olfactory impairment is one of the cardinal symptoms of chronic rhinosinusitis with nasal polyps (CRSwNP). However, the effect of currently available therapeutic options on the recovery of the sense of smell is not well defined. The aim of this systematic review was to compile evidence on the impact of medical, surgical, and biological treatment on olfactory outcomes in patients with CRSwNP.
METHODS: This review was conducted by 2 reviewers according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The quality of evidence of all the studies included in the qualitative synthesis was evaluated using the Critical Appraisal Skills Programme (CASP).
RESULTS: Forty-four studies were included in the qualitative synthesis. These assessed sinonasal surgery (n=23), biologics (n=15), and conventional medical treatment (n=6). The methodological quality was moderate-to-high in most. Overall, significant improvements in the sense of smell were detected with all the interventions analyzed and measured using an objective tool, a subjective tool, or both. However, most studies used different outcome measures, thus hindering comparisons between interventions, and data on clinically relevant changes were missing.
CONCLUSIONS: Oral corticosteroids, biologics, and sinonasal surgery improve the olfactory impairment associated with CRSwNP. However, the heterogeneous nature of existing studies does not allow accurate comparisons.
METHODS: This review was conducted by 2 reviewers according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The quality of evidence of all the studies included in the qualitative synthesis was evaluated using the Critical Appraisal Skills Programme (CASP).
RESULTS: Forty-four studies were included in the qualitative synthesis. These assessed sinonasal surgery (n=23), biologics (n=15), and conventional medical treatment (n=6). The methodological quality was moderate-to-high in most. Overall, significant improvements in the sense of smell were detected with all the interventions analyzed and measured using an objective tool, a subjective tool, or both. However, most studies used different outcome measures, thus hindering comparisons between interventions, and data on clinically relevant changes were missing.
CONCLUSIONS: Oral corticosteroids, biologics, and sinonasal surgery improve the olfactory impairment associated with CRSwNP. However, the heterogeneous nature of existing studies does not allow accurate comparisons.
摘要：
背景：嗅觉障碍是慢性鼻窦炎伴鼻息肉（CRSwNP）的主要症状之一，然而，目前可用的治疗方案对嗅觉恢复的影响尚不明确。这项系统评价的目的是收集医学影响的证据，外科,和生物疗法对CRSwNP患者嗅觉结局的影响。
方法：本综述由两名评审员进行，根据系统审查和荟萃分析(PRISMA)指南的首选报告项目。使用关键评估技能计划（CASP）评估定性综合中包含的所有研究的证据质量。
结果：定性综合纳入了44项研究（评估鼻窦手术[n=23]，生物制剂[n=15]，和常规医学治疗[n=6]）；大多数具有中等至高的方法学质量。总的来说,通过客观或主观工具(或两者)测量的所有分析干预措施均检测到嗅觉的显著改善.然而,大多数研究使用不同的结果测量，阻碍干预措施之间的比较，临床相关变化的数据缺失.
结论：口服皮质类固醇，生物制剂和鼻窦手术改善与CRSwNP相关的嗅觉障碍，但是现有研究中的高度变异性无法进行准确的比较.
方法：本综述由两名评审员进行，根据系统审查和荟萃分析(PRISMA)指南的首选报告项目。使用关键评估技能计划（CASP）评估定性综合中包含的所有研究的证据质量。
结果：定性综合纳入了44项研究（评估鼻窦手术[n=23]，生物制剂[n=15]，和常规医学治疗[n=6]）；大多数具有中等至高的方法学质量。总的来说,通过客观或主观工具(或两者)测量的所有分析干预措施均检测到嗅觉的显著改善.然而,大多数研究使用不同的结果测量，阻碍干预措施之间的比较，临床相关变化的数据缺失.
结论：口服皮质类固醇，生物制剂和鼻窦手术改善与CRSwNP相关的嗅觉障碍，但是现有研究中的高度变异性无法进行准确的比较.
