Intranasal trigeminal sensitivity: measurements before and after nasal surgery

Abstract

Nasal surgeries constitute an extensive manipulation of the nasal mucosa and therefore of structures related to trigeminal and olfactory sensitivity. While olfactory changes due to nasal surgery are relatively well investigated, there are only very few studies regarding trigeminal sensitivity. Aim of the present study was to investigate sensory changes after nasal surgery with special regard to the trigeminal sensitivity. In 38 patients prior to and around 12 weeks after nasal surgery the following psychophysical measures were performed: odor identification, odor discrimination, phenyl ethyl alcohol odor threshold, sensitivity to trigeminal stimuli, trigeminal detection thresholds and trigeminal pain thresholds. These results were compared to those of a control group (43 healthy volunteers). Psychophysical olfactory and trigeminal testing showed no major changes in patients after surgery compared to the control group. Independent from the time of measurement higher trigeminal detection thresholds were found in patients compared to healthy subjects, meaning that trigeminal thresholds were already increased before surgery. The present study revealed a decreased trigeminal sensitivity in patients already before surgery. It may be hypothesized that patients also exhibit a decreased sensitivity for nasal airflow, which may also contribute to the patients' impression of impaired nasal breathing.

Intranasal trigeminal function in patients with empty nose syndrome

“…The comparison between patients having concomitant septoplasty or not showed no difference in trigeminal function and subjective patency perception. Scheibe et al studied the trigeminal function of patients before and after septoplasty and found a decreased trigeminal sensitivity in patients before surgery . In the same study, septal surgery had no effect to the trigeminal sensitivity, a fact that is in agreement with our results.…”

Trigeminal sensitivity in chronic rhinosinusitis: topographical differences and the effect of surgery

“…Thus, increased patency perception could be achieved through mucosal heat loss/ cooling (7,8) . Further, a higher trige-minal detection threshold in patients undergoing septoplasty compared to healthy subjects revealed the important role of endonasal trigeminal sensitivity in patients with nasal breathing difficulties scheduled for surgery (9) .…”

Effects of “trigeminal training” on trigeminal sensitivity and self-rated nasal patency

“…However, there is empirical evidence suggesting that trigeminal sensitivity does not improve with surgical interventions such as sinus surgery [21]. In fact, a subjectively congested nose may not exclusively have an anatomical origin but might also result from insensitivity of the nasal trigeminal nerve.…”