Septoplasty and/or inferior turbinoplasty produce significant improvements of the sense of smell

P Mackers; M J Rojas-Lechuga; C Langdon; A NoguÃ S; J Mullol; I Alobid

doi:10.4193/Rhin22.461

Septoplasty and/or inferior turbinoplasty produce significant improvements of the sense of smell

Rhinology. 2023 Oct 1;61(5):421-431. doi: 10.4193/Rhin22.461.

Authors

P Mackers¹, M J Rojas-Lechuga², C Langdon³, A NoguÃ S⁴, J Mullol⁵, I Alobid⁶

Affiliations

¹ Rhinology and Skull Base Units, Smell Clinic, Otorhinolaryngology Department Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; and Otorhinolaryngology Department, Hospital del Mar, Barcelona, Catalonia, Spain.
² Rhinology and Skull Base Units, Smell Clinic, Otorhinolaryngology Department Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain.
³ Rhinology and Skull Base Units, Smell Clinic, Otorhinolaryngology Department Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; and Otorhinolaryngology Department, Hospital Sant Joan de Deu, Barcelona, Catalonia, Spain.
⁴ Rhinology and Skull Base Units, Smell Clinic, Otorhinolaryngology Department Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; and Otorhinolaryngology Department Consorci Sanitari Alt Penedes Garraf. Barcelona, Catalonia, Spain.
⁵ Rhinology and Skull Base Units, Smell Clinic, Otorhinolaryngology Department Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; and Clinical and Experimental Respiratory Immunollergy, IDIBAPS, Barcelona, Catalonia, Spain; and CIBER of Respiratory Diseases (CIBERES), Health Institute Carlos III, Spain.
⁶ Rhinology and Skull Base Units, Smell Clinic, Otorhinolaryngology Department Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; and Clinical and Experimental Respiratory Immunollergy, IDIBAPS, Barcelona, Catalonia, Spain; and CIBER of Respiratory Diseases (CIBERES), Health Institute Carlos III, Spain; and Unidad Alergo Rino, Centro Medico Teknon, Barcelona, Catalonia, Spain.

PMID: 37475674
DOI: 10.4193/Rhin22.461

Abstract

Background: Patients with septal deviation and/or turbinal hypertrophy may experience olfactory disfunction (OD). The aim of this study was to analyse the effect of septoplasty and/or turbinoplasty on both lateralized and bilateral olfactory function.

Methodology: Prospective study of 47 patients with nasal obstruction secondary to septal deviation and/or turbinal hypertrophy and 20 healthy controls. The Barcelona Olfactory test (BOT-8), a new supraliminal orthonasal subjective olfactometry, was applied 3 times in a row (in each nostril separately and in both simultaneously). The 8 items were applied randomly to minimize the possible risk of learning. The test has not established the minimal clinically important difference (MCID). Anterior rhinomanometry and acoustic rhinometry were performed. All participants self-assessed smell loss and nasal obstruction using a visual analogue scale (VAS) and completed questionnaires for nasal obstruction (Nasal Obstruction Symptom Evaluation, NOSE) and for quality of life (QoL), using disease-specific (SinoNasal Outcome Test-22, SNOT-22) and generic (Short Form-12 Health Survey, SF-12) questionnaires. Nasal measurements and questionnaires were performed preoperatively and 12 months after surgery.

Results: Before surgery, patients reported worse VAS on smell loss and on nasal obstruction compared to controls. Patients scored lower BOT-8 than controls. Lateralized preoperative olfactory function showed that all BOT-8 characteristics were lower at the narrow side than the wider one. Smell function and QoL improved significantly one year after surgery.

Conclusions: Nasal septal deviation and turbinal hypertrophy lead to an olfactory impairment on the obstructed nostril. Nasal surgery provides a positive outcome on olfactory function, as well as on subjective and objective outcomes.

MeSH terms

Anosmia / surgery
Humans
Nasal Obstruction* / diagnosis
Nasal Obstruction* / surgery
Nasal Septum / surgery
Nose Deformities, Acquired* / surgery
Prospective Studies
Quality of Life
Rhinoplasty*
Smell
Treatment Outcome