Effects of Septoplasty on Olfactory Function Evaluated by the Brief Smell Identification Test: A Study of 116 Patients

Abstract

We conducted a prospective study of 116 patients-61 men and 55 women, aged 17 to 64 years (mean: 26.4)to investigate the effects of septoplasty on olfactory function in patients with septal deviation (SD). The Mladina classification system was used to define SD types, and olfactory function was assessed with the Brief Smell Identification test (BSIT). The BSIT, which includes 12 odorants, was administered preoperatively and at postoperative months 1 and 3. The most common SD types were types 2 (20.7% of patients) and 1 (19.0%), followed by types 3 and 5 (both 16.4%). At postoperative month 1, the mean BSIT score was significantly higher in men than in the women. For patients with types 1 and 2 SD, BSIT scores at 1 month were significantly lower than the scores preoperatively and 3 months postoperatively. For types 3 and 4, BSIT values were significantly higher at 3 months than preoperatively or at 1 month. For type 3 SD, the preoperative mean score was significantly lower than those for types 1, 4, 5, 6, and 7; for type 2 SD, the BSIT score was significantly lower than those of types 5 and 6 only. At 1 month, the scores for types 2 and 3 were significantly lower than those for types 4, 5, 6, and 7. At 3 months, the BSIT score for type 2 was significantly lower than those of types 1, 3, 4, 5, and 6; the type 3 SD score at 3 months was significantly higher than those for types 1, 2, 5, 6, and 7. We conclude that septoplasty surgery for patients with a type 3 SD may improve olfactory function. In contrast, we found that olfactory function in patients with a type 2 SD did not improve to a satisfactory degree, even when good nasal patency was achieved with a corrected septum and an enlarged intranasal volume. Our findings should be investigated further in future studies. * Kruskal-Wallis variance analysis. † Friedman test.

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

“…[7][8][9][10] To date, there are a few studies evaluating the effects of septal surgery on olfactory function. 1,[11][12][13][14][15][16][17][18] However, the impact of olfactory impairment due to septal deviation on the nasal-symptom related and general QoL of the patients has not been adequately addressed in the literature. In addition, although there are studies investigating predictive factors for QoL outcomes after septoplasty, [19][20][21][22][23][24][25] there is no data available to the relevance of the olfactory function specifically to patients' psychological status (anxiety and depression symptoms) and its effect on their satisfaction with the surgical procedure and postoperative QoL recovery.…”

Change in olfactory function after septoplasty. A systematic review and meta-analysis

“…Berkiten et al (13) , 2016 SP CCCRC 6 w Mean score of 3.81 (0.89) Statistically significant improvement Dalgic et al (14) , 2016 Miyake et al (16) , 2016 Randhawa et al (17) , 2016 SRP SST (OD) 12 w NR Significant change in SST score. 58% improved, 35% remained the same, 7% worsened Haytoglu et al (18) , 2017 Turk et al (19) , 2017 SP SST (OT, OD, OI) 6 w 33.3% of patients were normosmic, 60.0% hyposmic, and 6.7% anosmic Significant improvement in SST scores. 63.3% of patients were normosmic, 36.7% hyposmic, and none anosmic 6 w after surgery.…”

“…STATA® 16.0 (StataCorp., College Station, TX, USA) software was used for the meta-analysis. The difference in means in olfactory function was calculated for 2 studies reporting BSIT scores (12,18) , 4 reporting CCCRC scores (6,13,15,20) , 4 reporting all three subsets of the Sniffin' Sticks test (4,5,14,21) and 2 reporting SST OI scores (10,11) .…”

“…Septoplasty is the standard treatment for nasal septum deviation because it generally results in improved nasal airflow and resolution of nasal obstruction symptoms; however, it is not without side effects (9) . To date, there are multiple studies evaluating the effects of septal surgery on olfactory function and nasal symptoms with conflicting results (2,(4)(5)(6)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) .…”

Olfactory Bulb Volume and Olfactory Sulcus Depth in Patients With OSA: An MRI Evaluation

“…The difference between our study and Fu et al's study 34 may be related to the degree of the nasal obstruction. Complete nasal obstruction or more anteriorly located nasal SD near to the nasal valve (ie, Mladina type 2 nasal SD) 35 may reduce the transfer of the nasal odorants to the olfactory epithelium; and OB volume decrease may be more prominent in these patients. One of the limitations of our study is that we did not evaluate the classification of the nasal SD as complete obstruction or not; and in the future, we will plan to evaluate the nasal obstruction degree and investigate the OB volume and OS depth in these patients.…”