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Eosinophilic inflammation has been implicated as a potential causative factor. However, prior studies have been limited by retrospective study designs, concomitant use of systemic corticosteroids, and other confounding factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>CRS and healthy non\u2010CRS control subjects undergoing endoscopic sinus or skull\u2010base surgery were prospectively enrolled and completed olfactory testing utilizing the 40\u2010item Smell Identification Test (SIT) immediately prior to surgery. Histopathological evaluation of tissue excised from the ethmoid bulla was performed by a pathologist in a blinded fashion. Disease severity and patient\u2010reported outcomes were measured via the Lund\u2010Mackay computed tomography (CT) grading system and 22\u2010item Sino\u2010Nasal Outcome Test (SNOT\u201022), respectively. The associations between olfactory function, tissue eosinophilia, and disease severity were analyzed using Spearman rank order correlation and multiple linear regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010seven (27) subjects with CRS without nasal polyps (CRSsNP), 32 subjects with CRS with nasal polyps (CRSwNP), and 10 healthy non\u2010CRS controls were enrolled. CRSwNP was associated with higher mean tissue eosinophil counts (71.6 vs 28.1 eosinophils\/high\u2010power field [HPF], <jats:italic>p<\/jats:italic> &lt; 0.05) and lower age\/sex\u2010adjusted SIT scores (\u221217.4 vs \u22126.2, <jats:italic>p<\/jats:italic> &lt; 0.001) when compared to CRSsNP. SIT scores were strongly negatively correlated with tissue eosinophil counts in CRSwNP (<jats:italic>r<\/jats:italic> = \u22120.60, <jats:italic>p<\/jats:italic> = 0.0003), but not CRSsNP (<jats:italic>r<\/jats:italic> = 0.16, <jats:italic>p<\/jats:italic> = 0.42). The correlation between olfactory function and tissue eosinophilia in CRSwNP persisted after adjusting for disease severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Tissue eosinophilia is associated with olfactory loss in CRSwNP, independent of disease severity. These results suggest a possible role for eosinophils or eosinophil\u2010associated cytokines in CRS\u2010associated olfactory loss.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21994","type":"journal-article","created":{"date-parts":[[2017,7,25]],"date-time":"2017-07-25T14:46:36Z","timestamp":1500993996000},"page":"957-962","source":"Crossref","is-referenced-by-count":80,"title":["Role of tissue eosinophils in chronic rhinosinusitis\u2013associated olfactory loss"],"prefix":"10.1002","volume":"7","author":[{"given":"Leah J.","family":"Hauser","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Vanderbilt University School of Medicine  Nashville TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh K.","family":"Chandra","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Vanderbilt University School of Medicine  Nashville 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