الفهرس 
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Abstract
This prospective study started with 100 adults patients suffering from chronic rhinosinusitis (CRS) confirmed by Computerized Tomography paranasal sinuses (CT PNS) whose medical treatment has been insufficient and whom were candidates to undergo functional endoscopic sinus surgery (FESS). The patients’ olfaction was evaluated before functional endoscopic sinus surgery (FESS) and re-evaluation done after three, six, twelve months and 2 years to assess the effectiveness of the FESS on olfaction during the duration of the study which was 4 years starting from November 2014 at Tanta University Hospital. The aim of this work was to study olfactory changes after endoscopic sinus surgery in patients with chronic rhinosinusitis and to compare patients’ olfaction (qualitative and quantitative) before and after FESS. All patients were subjected to: 1. Full history taking. 2. Anterior rhinoscopy. 3. Endoscopic nasal examination 4. Description of the operation to the patient. 5. FESS has been done using hypotensive anesthesia using Messerklinger-Stammberger technique.6. Follow up was done after three, six, twelve months and 2 years by clinical examination and olfactory testing using the Connecticut Chemosensory Clinical Research Center (CCCRC), In our study olfaction has been evaluated both quantitatively and qualitatively. The first examination (quantitative) called Threshold test or Luminary test. The second examination (qualitative) called smell identification test or supraliminal test. Finally, an evaluation of the trigeminal nerve was done with 4% butanol. Patients were asked for other symptoms as nasal obstruction, post nasal discharge & headache and these symptoms were evaluated by visual analogue score (VAS) pre & post FESS. We divided the patients involved in this study after endoscopic nasal examination into main two groups group A Including 39 patients presented by chronic rhinosinusitis with sinonasal polyposis ( CRSwNP). group B Including 61 patients presented by chronic rhinosinusitis without sinonasal polyposis (CRSsNP).At the end of research and after performing statistical analysis for the results, it was concluded that: Olfaction was significantly improved both quantitatively and qualitatively after FESS in patients presented preoperatively by severe hyposmia in both groups. But only in group (A) patients presented preoperatively by anosmia and moderate hyposmia also were significantly improved. The best symptom recorded to be improved post operatively was nasal obstruction which improved signicantly in both groups A and B but patients in group A were more satisfied by the operation (as regard nasal obstruction) rather than patients in group B As regard subjective score for headache which was evaluated by visual analogue score (VAS), patients showed significantly improvement post operatively in both groups more in group A. By using VAS for post nasal discharge, patients in both groups showed significantly improvement post operatively.