The Impact of Olfactory Dysfunction on the Psychological Status and Quality of Life of Patients with Nasal Obstruction and Septal Deviation

Abstract

Introduction Olfactory dysfunction may be present in patients with nasal obstruction and septal deviation. The impact of olfactory dysfunction on the psychological profile and quality of life (QoL) of these patients remains unexplored. Objective The present study aimed to investigate the emotional status and QoL of patients with olfactory dysfunction and septal deviation and to identify predictors associated with clinically significant improvement of psychological status and QoL, focusing mainly on the role of olfactory recovery after septoplasty. Methods The olfactory function was quantitatively assessed using the ‘‘Sniffin’ sticks'' test (Burghart Messtechnik GmbH, Wedel, Germany) in 60 patients and 25 controls enrolled in this prospective study. The participants completed validated questionnaires specific for general health (Short Form-36), nasal-symptom related QoL (SinoNasal Outcome Test-22), olfaction-associated QoL (Questionnaire of Olfactory Deficits) and for assessing their psychological state (Short Anxiety Screening Test and Beck Depression Inventory) preoperatively and 6 months postoperatively. The patients used the Glasgow Benefit Inventory to evaluate their personal benefit after septoplasty with. Results Septoplasty led to significantly improved olfactory function. Patients with olfactory impairment had significantly lower nasal-symptom related QoL, higher stress levels, and more depressive mood compared with normosmics and controls before and after septoplasty. Postoperatively, personal benefit from surgery was higher in normosmic patients. Improvement of nasal-symptom related QoL was significantly associated with higher likelihood of clinically significant improvement of patients' psychological profile and more personal benefit from surgery. Olfactory dysfunction was negatively correlated with the emotional status of the patients. Conclusion Olfactory dysfunction appears to significantly affect the psychological status of patients with nasal obstruction, and olfactory recovery improves the patients' perception of personal benefit from septoplasty.

Associations of Symptomatic- and Anatomical-Based Severity of Chronic Rhinosinusitis With Patients' Anxiety and Depression

“…In our results, nasal symptoms and facial/ear symptoms also affected anxiety and depression in CRS patients, and there were many other studies had similar conclusions to ours (10,36,37,48,49) . Nasal and facial/ear symptoms include discharge, olfactory dysfunction, running nose, headache and ear fullness.…”

“…Nasal and facial/ear symptoms include discharge, olfactory dysfunction, running nose, headache and ear fullness. A previous study (49) have found that olfactory dysfunction seriously damages the patients' nasal-symptom-related QoL. Compared with the control group, CRS patients showed a higher level of psychological stress and depression.…”

What About Using Sniffin’ Sticks 12 Screening Test to Identify Post-Covid-19 Olfactory Disorders?

“…Screening for olfactory disorders is important because, in addition to allowing to set up appropriate care for patients, it helps prevent the occurrence of consequences of long-term anosmia like an alteration in the quality of life (5) , psychiatric disorders such as depression (6,7) , anxiety, anorexia (8) and its nutritional consequences (9) , social interaction disorders (10,11) or cognitive impairment (10,12,13) . Although a subjective olfactory complaint (80% anosmia, 20% hyposmia) is now a very frequent symptom of a COVID-19 infection (2) affecting 70 to 85% of patients (32,33) , only 21% of clinicians use psychophysical olfactory tests to characterize this olfactory complaint (20) .…”

“…Anosmia can be the only COVID-19 symptom in to 26% of cases (2)(3)(4) . The long-term anosmia can cause an alteration in the quality of life (5) and psychiatric disorders such as depression (6,7) , anxiety, anorexia (8) and its nutritional consequences (9) , social interaction disorders (10,11) and cognitive impairment (10,12,13) .…”

“…Anosmia can be the only COVID-19 symptom in 11 to 26% of cases (2–4) . The long-term anosmia can cause an alteration in the quality of life (5) and psychiatric disorders such as depression (6,7) , anxiety, anorexia (8) and its nutritional consequences (9) , social interaction disorders (10,11) and cognitive impairment (10,12,13) . So, the diagnosis of olfactory disorders and their management is essential especially as 6 (14) and 12 (16) months after the COVID-19 infection, respectively 60% and 30% of patients retain an olfactory complaint and require attention.…”