So many patients with nasal disorders have poor olfactory function, yet sometimes the nose may seem comparatively clear of conductive problems. This study postulated that neuronal damage in the olfactory apparatus would lead to a leakage of neuron specific enolase into the nasal secretions. They studied patients with chronic sinusitis, with and without polyps, and normal controls, including olfactory assessment as well as analysing secretions for neuron specific enolase. The higher the levels of this protein in the secretions, the poorer the olfactory function. Controls had lower levels than CRS patients, and polyp patients had higher levels than patients without polyps. What this means at a practical level, it is hard to say at this stage, but it does help to explain the multiple mechanisms of olfactory dysfunction in our patients. 

Neuron specific enolase in nasal secretions as a novel biomarker of olfactory dysfunction in chronic rhinosinusitis.
Tysbikov NN, Egorova EV, Kuznik BI, et al.
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Edward W Fisher

MA DM FRCS, University Hospitals Birmingham NHS Trust (Heartlands and Good Hope Hospitals); Editor, Journal of Laryngology and Otology.

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