Background: Olfactory dysfunction is a common symptom of chronic rhinosinusitis (CRS), affecting approximately 60-80% of patients. This impairment significantly impacts patients' quality of life and increases the risk of hazardous events.

Objective: This study aims to summarize and analyze the epidemiology, risk factors, and pathogenesis of CRS-related olfactory dysfunction. It also describes subjective and objective methods for olfactory assessment and discusses the latest diagnostic and therapeutic approaches, while proposing future research directions.

Methods: A comprehensive literature review was conducted to analyze the pathophysiology, clinical characteristics, and treatment strategies for CRS-related olfactory dysfunction. This study compares different olfactory assessment tools, examines the role of inflammatory factors, and evaluates the effectiveness of various treatments.

Results: The pathogenesis of CRS-related olfactory dysfunction involves conductive factors, inflammatory processes, and olfactory bulb disuse atrophy. While surgical and pharmacological treatments are effective for some patients, the overall efficacy remains debatable. Traditional olfactory training emerges as a promising, non-invasive therapeutic approach with significant potential.

Conclusions: Olfactory dysfunction is a prevalent issue among CRS patients and is closely associated with type 2 inflammation. Future research should focus on understanding the dynamic changes in olfactory bulb volume and the functional transition of olfactory neuroepithelial stem cells. Although corticosteroid therapy is widely used, the optimal administration route requires further investigation, and the long-term efficacy of surgical treatment remains a topic of ongoing debate.

Keywords: Imaging techniques; Neuroepithelial stem cells; Olfactory dysfunction; Olfactory testing; Psychophysical testing; Rhinosinusitis; Traditional Chinese medicine.

© 2025. The Author(s).

背景：

嗅觉障碍是慢性鼻窦炎（CRS）的常见症状，影响约60-80%的患者。这种功能受损显著影响患者的生存质量，并增加了发生危险事件的风险。

目的：

本研究旨在总结和分析与CRS相关的嗅觉障碍的流行病学、风险因素及发病机制。同时描述主观和客观评估嗅觉的方法，讨论最新的诊断和治疗途径，并提出未来的研究方向。

方法：

进行了全面的文献回顾，以分析CRS相关嗅觉障碍的病理生理学、临床特征和治疗方法。本研究比较了不同的嗅觉评估工具，考察了炎症因子的作用，并评估了各种治疗方法的有效性。

结果：

CRS相关的嗅觉障碍发病机制涉及传导因素、炎症过程以及嗅球废用性萎缩。尽管手术和药物治疗对某些患者有效，但整体疗效仍有争议。传统的嗅觉训练作为一项有前景的非侵入性疗法，显示出显著潜力。

结论：

嗅觉障碍是CRS患者的常见问题，并且与2型炎症密切相关。未来的研究应重点关注嗅球体积的动态变化以及嗅觉上皮干细胞的功能转换。虽然糖皮质激素治疗被广泛应用，但最佳给药途径仍需进一步研究，手术治疗的长期疗效依然是一个值得持续探讨的话题。

关键词：

成像技术；神经上皮干细胞；嗅觉障碍；嗅觉测试；心理物理学测试；鼻窦炎；中医。