International Rhinologic Society Rhinology 0300-0729 55 1 2017 3 1 28214351 Evidence-based and precision medicine two of a kind 1 2 EN W.J. Fokkens Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands 1536 10.4193/Rhin17.401 In the last two decades, an enormous expansion of evidence has been produced in upper airway research. When writing the first EPOS document in 2005 only 5 RCT per year were performed in the area of CRS, in 2007 this changed to 25 per year and it became even higher in the recent years. Randomized Controlled Trials (RCTs) are the "gold standard" for evaluating treatment outcomes providing information on treatments "efficacy". To make life easier for clinicians, systematic reviews and meta-analysis further condense the available evidence.

International Rhinologic Society Rhinology 0300-0729 55 1 2017 3 1 28214353 Association of gastro-oesophageal reflux and chronic rhinosinusitis: systematic review and meta-analysis 3 16 EN S.R. Leason Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, University of New South Wales, Sydney, Australia H.P. Barham Department of Otolaryngology Head and Neck Surgery, Louisiana State University, New Orleans, LO, USA G. Oakley Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, University of New South Wales, Sydney, Australia J. Rimmer St Vincents Clinic, St Vincents Hospital, Sydney, Australia J.M. DelGaudio Division of Rhinology and Sinus Surgery, Department of Otolaryngology, Emory University School of Medicine, Atlanta, GA, USA J.M. Christensen Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, University of New South Wales, Sydney, Australia R. Sacks Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, University of New South Wales, Sydney, Australia R.J. Harvey Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, University of New South Wales, Sydney, Australia 1537 10.4193/Rhin16.177 INTRODUCTION: Gastro-oesophageal reflux disease (GORD) has been implicated in the development of chronic rhinosinusitis (CRS). The association of GORD with CRS is systematically assessed from the medical literature. METHODOLOGY: Embase and MEDLINE were searched using a comprehensive strategy limited to English language and Human subjects. Any study with original data on the experimental, diagnostic, treatment or prognostic association of CRS with GORD was included. Studies without a control group, case reports and review articles were excluded. RESULTS: The search returned 958 records, with an additional 10 found from bibliographic lists; this produced 32 studies. The included studies (n=32) consisted of studies reporting pathogenic factors (n=20), epidemiological association (n=8), prognostic interactions (n=3), and a combination of these outcomes (n=1). Potential pathogenic roles for GORD in CRS were supported; CRS subjects had greater prevalence of intranasal Helicobacter pylori and acid reflux than subjects without CRS. CRS is more prevalent in GORD sufferers than those without GORD. Evidence is conflicting for GORD as a factor in CRS treatment failure. CONCLUSION: The results support a significant association of GORD with CRS. Physicians should be cognizant of the potential for acid and non-acid reflux as a driving factor in CRS.

International Rhinologic Society Rhinology 0300-0729 55 1 2017 3 1 28040824 Effects of olfactory training: a meta-analysis 17 26 EN A. Sorokowska Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany E. Drechsler Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany M. Karwowski The Maria Grzegorzewska University, Warsaw, Poland T. Hummel Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany 1517 10.4193/Rhin16.195 The neural plasticity of the olfactory system offers possibilities of treatment in terms of stimulation of the sense of smell, and different studies have suggested effectiveness of smell training, i.e., daily exposition to certain odors. To obtain reliable and precise estimates of overall treatment benefit on the olfactory function, we meta-analyzed the effects of smell training reported in 13 previous studies. We analyzed the smell training effectiveness across three different olfactory abilities, smell identification, discrimination and threshold for odor detection. We found a significant, positive effect of olfactory training for all olfactory abilities, with large effects of training on identification, discrimination and TDI-score and small-to-moderate effect in the case of threshold for odor detection. Interestingly, the pattern of results differed across Sniffin Sticks subtests depending on the origin of participants smell disorder, and the smell training duration influenced its effectiveness in the case of identification and the TDI score. Although the exact mechanism of olfactory recovery following the smell training still requires further investigation, our meta-analysis showed that such training should be considered an addition or alternative to existing smell treatment methods.

International Rhinologic Society Rhinology 0300-0729 55 1 2017 3 1 28214352 Gastro-oesophageal reflux in patients with chronic rhino-sinusitis investigated with multichannel impedance - pH monitoring 27 33 EN E.J. Katle Department of Otolaryngology, Head and Neck Surgery, Stavanger University Hospital, Stavanger, Norway J.G. Hatlebakk Department of Medicine, Haukeland University Hospital, Norway T. Grimstad Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway J.T. Kvaløy Department of Mathematics and Natural Sciences, University of Stavanger, Norway S.K. Steinsvåg Department of Mathematics and Natural Sciences, University of Stavanger, Norway 1542 10.4193/Rhin16.275 INTRODUCTION: The pathophysiology of chronic rhinosinusitis (CRS) is unclear. It has been discussed for decades whether gastro-oesophageal reflux (GOR) may be a contributing factor for some patients. The aim of the present study was to evaluate the level of GOR in an unselected group of patients with CRS using multichannel impedance-pH monitoring. METHODS: Consecutive patients with CRS diagnosed using the EPOS2012 criteria, completed questionnaires on GOR symptoms and were offered 24-h multichannel intraluminal impedance (MII)-pH monitoring. The results were compared with a group of healthy controls. RESULTS: Forty-six patients completed MII-pH-monitoring and were compared with 45 control subjects, with comparable age and gender distributions. The median number of reflux episodes in the patients was 56.5 compared with 33 in controls, while, the numbers of proximal reflux episodes was 27.5 versus 3, respectively. Thirty nine patients had abnormal pH-impedance recordings compared with five controls. CONCLUSION: The CRS patients had significantly higher incidences of gastro-oesophageal reflux compared with asymptomatic controls. The results of this study suggest that GOR may be a causative or contributing factor of CRS.

International Rhinologic Society Rhinology 0300-0729 55 1 2017 3 1 28019644 Allergic rhinitis severity can be assessed using a visual analogue scale in mild, moderate and severe 34 38 EN A. Del Cuvillo Unidad de Rinologia y asma, UGC ORL Hospital de Jerez del Servicio Andaluz de Salud, Cadiz, Spain V. Santos Fundacion para la gestion de la Investigacion Biomedica de Cadiz, Spain J. Montoro Unidad de Alergia, Hospital Universitario Arnau de Vilanova, Facultad de Medicina, Universidad Catolica de Valencia San Vicente Martir, Valencia, Spain J. Bartra Unitat d Al.lergia, Servei de Pneumologia i Al.lergia Respiratoria, Hospital Clinic, Universitat de Barcelona, CIBERES, Barcelona, Spain I. Davila Servicio de Alergia, Hospital Universitario, IBSAL, Salamanca, Spain M. Ferrer Departamento de Alergologia e Inmunologia Clinica, Clinica Universidad de Navarra, Pamplona, Spain I. Jauregui Servicio de Alergia, Hospital Universitario de Basurto, Bilbao, Spain J. Sastre Servicio de Alergia, Fundacion Jimenez Diaz, CIBERES, Madrid, Spain J. Mullol Unitat de Rinologia i Clinica de l Olfacte, Servei dOtorinolaringologia, Hospital Clinic, Universitat de Barcelona, CIBERES, Barcelona, Spain A. Valero Unitat d Al.lergia, Servei de Pneumologia i Al.lergia Respiratoria, Hospital Clinic, Universitat de Barcelona, CIBERES, Barcelona, Spain 1522 10.4193/Rhin16.025 BACKGROUND: Allergic rhinitis is a global healthcare problem due to its high prevalence, impact on individuals and socioeconomic burden for the nations. Allergic rhinitis severity evaluation is the key to a correct treatment, prevention of comorbidities and improving the quality of life of patients. This evaluation should be made with a simple, easy, fast but accurate and reliable methodology, both in a primary care and specialist setting. The visual analogue scale (VAS) meets all requirements to be the ideal tool to assess allergic rhinitis severity and has already been validated by using a single cut-off point, but this classification in two degrees of severity suffer from not allocating the patients uniformly and from giving a blind interval to classify the patients when the score is between 5 to 6 cm. METHODOLOGY: The main objective of our study is to describe the optimal cut-off points by using a VAS to discriminate between three degrees of allergic rhinitis severity (mild, moderate, and severe) following the ARIA modified severity criteria that has been previously validated. Sensitivity, specificity, positive and negative predictive values just like receiver operating characteristic curves were used to select the best cut-off values. RESULTS: In a cross-sectional multicentre study with 3,572 patients included we have found that VAS has a significant correlation with nasal symptom score and quality of life and that the best cut-off points to differentiate between mild, moderate an severe allergic rhinitis are a VAS score of 4 and 7, respectively. CONCLUSIONS: Allergic rhinitis severity could be assessed in three degrees by using VAS in a simple, easy, and accurate method.

International Rhinologic Society Rhinology 0300-0729 55 1 2017 3 1 28025986 Responsiveness and reliability of the Sinus Control Test in chronic rhinosinusitis 39 44 EN P. Kohli Division of Rhinology and Sinus Surgery, Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA Z.M. Soler Division of Rhinology and Sinus Surgery, Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA K.A. Storck Division of Rhinology and Sinus Surgery, Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA A. Shahangian Division of Rhinology and Sinus Surgery, Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA S.M. Banglawala Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Toronto, ON, Canada R.J. Schlosser Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA 1525 10.4193/Rhin16.208 BACKGROUND: The Sinus Control Test (SCT) is a patient-reported questionnaire designed to help physicians identify sub-optimally controlled chronic rhinosinusitis (CRS). This study measures responsiveness to surgery and reliability of the SCT. METHODOLOGY: Adults meeting diagnostic criteria for CRS were recruited from rhinology clinics at a tertiary academic institution. To measure responsiveness, the SCT was administered at baseline and at least 3 months after surgery to 62 CRS patients. To measure reliability, the SCT was administered at two clinical encounters a maximum of 14 days apart to 22 CRS patients. RESULTS: Total SCT scores significantly improved from baseline to post-operative follow-up, and the distribution of patients with total SCT scores falling into the uncontrolled, partially controlled, and controlled categories before and after surgery were significantly different in the direction of improvement. The SCT met minimum standards for reliability and internal consistency as measured by: test-retest reliability coefficient, intra-class correlation coefficients, and item-total correlations. Cronbach alpha; values with each item deleted were lower than the overall Cronbach alpha. The SCT captures the full range of disease control as measured by floor and ceiling effects. CONCLUSION: The SCT is responsive to surgical intervention and a reliable tool to monitor changes in CRS control levels.

International Rhinologic Society Rhinology 0300-0729 55 1 2017 3 1 28019643 Sleep quality improves with endoscopic sinus surgery in patients with chronic rhinosinusitis and nasal polyposis 45 52 EN M. Värendh Department of Otorhinolaryngology, Skane University Hospital and Lund University, Sweden A. Johannisson Occupational Therapy and Occupational Science, Lund University, Sweden H. Hrubos-Strøm Department of Otorhinolaryngology, Akershus University Hospital, Lorenskog, Norway M. Andersson Department of Otorhinolaryngology, Skane University Hospital and Lund University, Sweden 1523 10.4193/Rhin16.065 BACKGROUND: Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP) is a chronic disease that has a major impact on generic and disease-specific quality of life. Little is known about the influence of CRSwNP on sleep and what effect surgery for CRSwNP has on sleep quality. The aim of the study was to investigate sleep quality in patients with CRSwNP before and after endoscopic surgery. METHODOLOGY: Forty-two patients filled out four validated sleep questionnaires and one sino/nasal, disease specific quality of life questionnaire before surgery and three months later. A healthy control group filled out the same questionnaires at baseline and after three months. RESULTS: An impact on sleep patterns was found in all sleep questionnaires and surgery clearly improved the quality of sleep. The Sino-nasal outcome test sum score decreased from median 51,5 to 26,5. Epworth sleepiness scale showed a decline in score from score 7.5 to 6.0. Surgery also reduced the risk for obstructive sleep apnoea in 13 patients evaluated by the Berlin Questionnaire and Multivariable Apnea Prediction Index. CONCLUSIONS: Patients with CRSwNP had impaired sleep quality, daytime sleepiness, nasal patency, and risk for sleep apnea, all of which improved after corrective surgery.

International Rhinologic Society Rhinology 0300-0729 55 1 2017 3 1 27665079 Neurologic sequelae associated with delayed identification of iatrogenic skull base injury during endoscopic sinus surgery (ESS) 53 58 EN M. Kubik Center for Cranial Base Surgery, Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA S. Lee Center for Cranial Base Surgery, Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA C. Snyderman Center for Cranial Base Surgery, Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA E. Wang Center for Cranial Base Surgery, Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA 1481 10.4193/Rhin16.169 Background: Skull base injury is an infrequent complication during endoscopic sinus surgery (ESS). We hypothesize that late recognition and repair of CSF leaks during ESS is associated with increased neurologic morbidity. Methodology: A retrospective review was performed of patients with skull base injury during ESS at a tertiary center from 1999-2015. The study population was separated into early (less than 72 hrs) and late (more than 72 hrs) intervention groups. Study parameters included time to diagnosis, imaging, site of injury, type of repair, neurologic complications, and clinical outcomes. Results: Seventeen patients were studied. The primary surgical interventions included ESS and balloon sinuplasty. Mean latency from primary surgery to presentation to our facility was 11 days. The most common injury site was the cribriform plate and the mean defect size 4.5 mm. Late diagnosis was associated with increased total neurologic complications and increased rates of postoperative meningitis. No neurologic complications occurred in patients diagnosed intraoperatively. All patients underwent successful endoscopic repair. Conclusion: Skull base injury is a rare but major complication following both balloon sinuplasty and traditional primary ESS. Early diagnosis and endoscopic repair may prevent neurologic morbidity in these patients.

International Rhinologic Society Rhinology 0300-0729 55 1 2017 3 1 28025987 Toll-like receptor activation by sino-nasal mucus in chronic rhinosinusitis 59 69 EN K. Biswas Department of Surgery, University of Auckland, New Zealand A. Chang School of Dentistry, University of Washington, Seattle, WA, USA M. Hoggard School of Biological Sciences, University of Auckland, New Zealand F.J. Radcliff Department of Molecular Medicine and Pathology, University of Auckland, New Zealand Y. Jiang Department of Statistics, University of Auckland, New Zealand M.W. Taylor School of Biological Sciences, University of Auckland, New Zealand R. Darveau Department of Molecular Medicine and Pathology, University of Auckland, New Zealand R.G. Douglas Department of Surgery, University of Auckland, New Zealand 1527 10.4193/Rhin16.201 BACKGROUND: The sino-nasal disease chronic rhinosinusitis (CRS) is primarily an inflammatory condition that manifests in several ways. However, the aetiology of this complex disease is poorly understood. The aim of this study was to explore the association between toll-like receptor (TLR) activation, host immune response and sino-nasal mucus in healthy and diseased patients. METHODS: The activation of TLR2/1 and TLR4 by sino-nasal mucus from 26 CRS patients and 10 healthy controls was measured. In addition, 7 inflammatory cytokines, bacterial community composition and bacterial abundance within the sino-nasal mucus were measured using molecular and diagnostic tools. RESULTS: TLR activity was observed in 9/36 samples, including 2 healthy controls. There was a strong, positive correlation between members of the Gammaproteobacteria (Haemophilus, Enterobacter, Pseudomonas) and TLR2/1 and TLR4 activity. Bacterial abundance and cytokine (tumour necrosis factor) abundance were also positively correlated with TLR activity. CONCLUSIONS: These findings suggest that a small proportion (20-30%) of individuals in each sub-group are more predisposed to TLR activity, which may be related to bacterial composition, diversity and abundance in the sinuses.

International Rhinologic Society Rhinology 0300-0729 55 1 2017 3 1 28026837 Trigeminal sensitivity in chronic rhinosinusitis: topographical differences and the effect of surgery 70 74 EN S.C. Poletti Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany M. Cuevas Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany S. Weile Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany T. Hummel Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany 1531 10.4193/Rhin16.194 Introduction: Little is known on endonasal trigeminal sensitivity in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). The aim of our study was to investigate changes in trigeminal sensitivity in patients with CRSwNP and the effect of functional endoscopic sinus surgery (FESS) on trigeminal perception. Methods: A prospective study was performed to investigate the trigeminal sensitivity at three different locations within the nose (anterior septum, anterior lateral wall, middle turbinate) using electrical stimuli. Therefore 45 CRSwNP patients were compared to 30 healthy subjects. Further, the effect of FESS was investigated in 31 patients before and 3 months after surgery. Results: CRSwNP patients had a significantly higher trigeminal threshold at all tested locations than healthy subjects. The lowest trigeminal detection threshold could be shown at the entrance of the nose in healthy subjects and in patients with CRSwNP. Three months after FESS a significant improvement of trigeminal detection threshold was observed at the anterior nasal septum. CONCLUSION: Protective function of the trigeminal system is preserved in CRSwNP patients. FESS seems to show beneficial effects on restoring sentinel function at the entrance of the nose.

International Rhinologic Society Rhinology 0300-0729 55 1 2017 3 1 28025985 Quality of life after primary septorhinoplasty in deviated- and non-deviated nose measured with ROE, FROI-17 and SF-36 75 80 EN O.C. Bulut Department of Otolaryngology, University of Heidelberg, Germany F. Wallner Department of Otolaryngology, University of Heidelberg, Germany R. Hohenberger Department of Otolaryngology, University of Heidelberg, Germany P.K. Plinkert Department of Otolaryngology, University of Heidelberg, Germany I. Baumann Department of Otolaryngology, University of Heidelberg, Germany 1528 10.4193/Rhin16.243 BACKGROUND: Quality of life measurements are gaining in importance. The present study was conducted with the aim to compare patient satisfaction after septorhinoplasty according to their preoperative nasal deformity. METHODS: The patients completed two disease-specific questionnaires before their surgery: the Functional Rhinoplasty Outcome Inventory (FROI-17), the Rhinoplasty Outcome Evaluation (ROE) and as a general instrument, the Short Form 36 Health Survey (SF-36). The second measurement was taken during an outpatient examination 12 months after their primary septorhinoplasty. Patients were grouped in nasal axis deviation (NAD), nasal hump deformity (NHD) and NAD plus NHD. Additionally the patients with preoperative NAD and NAD+NHD were combined as deviated nose and compared to the non-deviation group. RESULTS: One hundred and two patients (51 male and 51 female) underwent primary septorhinoplasty. The ROE- and the FROI-17 overall score including all three subgroups showed significant postoperative improvements. Regarding the SF-36, the postoperative score improved significantly only in two scales (role-functioning physical and mental health). Looking at the the different QoL questionnaires, there were significant postoperative differences in regards to deviated versus non-deviated nose in the FROI-17 overall- and FROI-17 subscores (nasal and general symptoms) and in three scales of the SF-36 (vitality, social functioning, role-functioning emotional), showing a greater postoperative satisfaction in the deviated-nose patient. CONCLUSION: Patients with and without nasal deviation showed improved QoL after their surgery, as measured with the ROE, the FROI-17 and the SF-36. The patients with a nasal deviation showed a significantly better outcome, as measured with the FROI-17, in comparison with the non-deviated group.

International Rhinologic Society Rhinology 0300-0729 55 1 2017 3 1 28060384 Effects of functional endoscopic sinus surgery on the acoustics of the sinonasal tract 81 89 EN M. Havel Dept. of Otorhinolaryngology, Head and Neck Surgery, Section Phoniatrics, Munich University Hospital, Munich, Germany S. Becker Dept. of Otorhinolaryngology, Head and Neck Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany M. Schuster ept. of Otorhinolaryngology, Head and Neck Surgery, Section Phoniatrics, Munich University Hospital, Munich, Germany T. Johnson Dept. of Radiology, Munich University Hospital, Munich, Germany A. Maier Dept. of Computer Science, Friedrich-Alexander-University, Erlangen, Germany J. Sundberg Dept. of Speech, Music and Hearing, School of Computer Science and Communication, KTH (Royal Institute of Technology), Stockholm, Sweden 1533 10.4193/Rhin16.229 BACKGROUND: Nasal and paranasal cavities are supposed to contribute substantially to the vocal tract resonator properties. However, their acoustical effects as well as the effects of sinus surgery on the voice remain unclear. In this work we investigate resonance phenomena of paranasal sinuses prior to and after various rhinosurgical procedures in cadaveric human sinonasal tracts and corresponding 3D casts. METHODOLOGY: Nasal and paranasal cavities of formalin-preserved cadavers and corresponding 3D replicas were excited by sine-tone sweeps from an earphone placed in the epipharynx. The response was picked up by a microphone at the nostrils. Different FESS procedures were performed and the acoustical responses following excitation were recorded. The measured acoustical changes in the obtained transfer functions were then evaluated. RESULTS: Marked low frequency dips were detected in the transfer functions when sinus cavities were included in the nasal resonator system. These dips showed a significant correlation with sinus volumes. Following FESS procedures they moved upwards in frequency depending on the extent of the surgical intervention. CONCLUSIONS: The transfer functions obtained in cadaveric situs and 3D replicas showed dips at the resonance frequencies of the paranasal cavities. Marked acoustic effects in terms of increase in dip frequency following FESS procedures were reproducibly documented.

International Rhinologic Society Rhinology 0300-0729 55 1 2017 3 1 28214914 The impact of bitter taste receptor genetics on culturable bacteria in chronic rhinosinusitis 90 94 EN D.I. Rom Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia J.M. Christensen Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia R. Alvarado Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia R. Sacks Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia R.J. Harvey Rhinology and Skull Base Research Group, St Vincents Centre for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia 1543 10.4193/Rhin16.181 BACKGROUND: Extra-oral bitter taste receptors have been associated with innate bacterial defence mechanisms. Genetic variation in T2R38 functionality has been shown to be associated with susceptibility to upper respiratory tract infections and chronic rhinosinusitis (CRS). We sought to independently assess the influence of bitter taste receptor genotype on the presence of culturable bacteria in the sinuses. METHODOLOGY: A cross-sectional analysis of patients with CRS undergoing surgery was performed. Middle meatal nasal swabs were sent for microbiological evaluation at the time of the procedure. Mucosal biopsies were taken and sent for bitter taste receptor genotype analysis. Sequencing of 3 polymorphisms in the TAS2R38 gene was performed to identify genotypes as super-tasters (PAV/PAV), non-tasters (AVI/AVI) or heterozygous expression (PAV/AVI). The presence of culturable organisms and common pathogens were compared with bitter taste receptor genotypes. RESULTS: 25 patients (age 52.4 +/- 18.28 years, 51% female) were assessed. Super-tasters comprised 16% of the group, 24% were non-tasters and 48% had heterozygous expression. A cultured pathogen was grown in 48% of patients; 32% gram-positive, 20% gram-negative, 28% grew Staphylococcus aureus and 12% Pseudomonas aeruginosa. A non-taster genotype was predictive of colonised pathogens. Tissue eosinophilia (more than 10 HPF) was seen in 48%. CONCLUSION: Even in a small sample of patients with CRS, non-taster T2R38 genotype appears to predict the presence of culturable bacteria colonising the sinus cavity at the time of surgery for their condition. A genetic link to patients more likely to become infected is likely.