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The article discusses chronic rhinosinusitis (CRS) with nasal polyposis (CRSwNP) as the leading cause of olfactory dysfunction in the general population. The article summarizes the current literature on the mechanisms behind olfactory dysfunction in CRSwNP and the impact of therapy on olfactory outcomes in this patient population. The review found evidence from clinical research and animal models suggesting both an obstructive component causing conductive olfactory loss and an inflammatory response in the olfactory cleft leading to sensorineural olfactory loss. The article highlights the efficacy of oral steroids and endoscopic sinus surgery in improving olfactory outcomes in CRSwNP in the short term, and newer targeted biologic therapies, such as dupilumab, have also shown remarkable and durable improvement in smell loss for CRSwNP patients. However, the long-term response of these treatments remains uncertain, and further studies are needed to elucidate the underlying basic mechanisms to develop future therapies targeted to improve olfactory dysfunction in patients with CRSwNP.
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