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Fearington FW, Awadallah AS, Hamilton GS, Olson MD, Dey JK. Long-Term Outcomes of Septoplasty With or Without Turbinoplasty: A Systematic Review. Laryngoscope 2024; 134:2525-2537. [PMID: 37991145 DOI: 10.1002/lary.31193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Septoplasty is used to correct nasal obstruction from nasal septum deviation. However, the long-term efficacy of septoplasty is unclear, and no literature reviews have examined long-term outcomes of septoplasty with or without turbinate modification. This systematic review aimed to evaluate the long-term efficacy of septoplasty with or without turbinate modification in improving nasal obstruction. DATA SOURCES PubMed, EMBASE, Cochrane CENTRAL. METHODS A systematic review of the literature was conducted using the aforementioned databases. Studies reporting outcomes 12+ months after functional septoplasty with or without turbinate surgery for nasal obstruction were included. Septorhinoplasties, concurrent sinus surgery, pediatric studies, and studies where septoplasty was performed for indications other than nasal obstruction were excluded. RESULTS After screening, 35 studies with 4,432 patients were included. Mean weighted post-operative follow-up time was 29.1 months (range 12-120 months). All studies reported significant improvement in subjective and objective outcomes at long-term follow-up compared to baseline. When comparing short-term (<12 months) to long-term (≥12 months) outcomes, four studies noticed that subjective outcomes worsened slightly over time, but no study found a significant change in objective outcomes over time. In addition, 23 studies reported patient satisfaction and/or improvement rates, with 75.4% (2,348/3,113) of patients expressing satisfaction/improvement at an average of 27.0 months after surgery. CONCLUSIONS Overall, septoplasty with or without turbinate modification shows significant improvement in obstructive symptoms at long-term follow-up per both objective and subjective measures. Whether outcomes may worsen slightly over time remains indeterminate based on mixed results in the literature. LEVEL OF EVIDENCE N/A Laryngoscope, 134:2525-2537, 2024.
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Affiliation(s)
| | | | - Grant S Hamilton
- Department of Otolaryngology-Head & Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
- Division of Facial Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Michael D Olson
- Department of Otolaryngology-Head & Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
- Division of Facial Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Jacob K Dey
- Department of Otolaryngology-Head & Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
- Division of Facial Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
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2
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Migliavacca RDO, Lavinsky M, de Souza OE, Friedrich EP, Cionek OAGD, Subda LF, Bernardi BL. Modified extracorporeal septoplasty: prospective study. Braz J Otorhinolaryngol 2024; 90:101398. [PMID: 38430860 PMCID: PMC10912845 DOI: 10.1016/j.bjorl.2024.101398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/13/2023] [Accepted: 12/26/2023] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVES This study aimed to evaluate quality-of-life and satisfaction outcomes in patients undergoing the MES using the Portuguese version of the Nasal Obstruction Symptom Evaluation (NOSE-p) and Rhinoplasty Outcome Evaluation (ROE), and also to evaluate the frequency of possible complications of this technique. METHODS We conducted a single-center prospective study with patients who had the indication for MES, from May 2016 to September 2020 at the Facial Plastic Surgery Clinic of Otolaryngology Department of the Hospital de Clinicas de Porto Alegre. The primary outcome was the relative postoperative change in NOSE-p. Secondary outcome was the variation in ROE, a validated quality-of-life questionnaire for rhinoplasty patients. RESULTS Of the 31 patients submitted to extracorporeal septorhinoplasty who were evaluated, twenty-seven patients were included. Preoperative and postoperative NOSE-p scale scores were 65.2 ± 29.9 and 23.5 ± 26.7, respectively (mean differences of 42.04; [95% CI 27.35-56.73]; p < 0.0001). Pre and postoperative ROE scores were 38.3 ± 24.3 vs. 67.29 ± 29.7, respectively (mean differences of -29.02; [95% CI -40.5 to -17.5]; p = 0.0001). Residual septal deviation was verified in 2 patients (7.4%). CONCLUSION Most of the patients submitted to modified extracorporeal septoplasty had a significant improvement in quality of life scores of nasal obstruction, with good aesthetical outcomes and low indices of postoperative complications. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- Raphaella de Oliveira Migliavacca
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Otorrinolaringologia, Programa de Pós-Graduação em Ciências Médicas: Otorrinolaringologia, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências Pneumológicas, Porto Alegre, RS, Brazil
| | - Michelle Lavinsky
- Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Otorrinolaringologia, Programa de Pós-Graduação em Ciências Médicas: Otorrinolaringologia, Porto Alegre, RS, Brazil
| | - Olívia Egger de Souza
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Otorrinolaringologia, Programa de Pós-Graduação em Ciências Médicas: Otorrinolaringologia, Porto Alegre, RS, Brazil
| | - Eduardo Priesnitz Friedrich
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Otorrinolaringologia, Programa de Pós-Graduação em Ciências Médicas: Otorrinolaringologia, Porto Alegre, RS, Brazil.
| | - Otávio Augusto Gonçalves Dias Cionek
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Otorrinolaringologia, Programa de Pós-Graduação em Ciências Médicas: Otorrinolaringologia, Porto Alegre, RS, Brazil
| | - Leonardo Ferreira Subda
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Otorrinolaringologia, Programa de Pós-Graduação em Ciências Médicas: Otorrinolaringologia, Porto Alegre, RS, Brazil
| | - Bárbara Luiza Bernardi
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Otorrinolaringologia, Programa de Pós-Graduação em Ciências Médicas: Otorrinolaringologia, Porto Alegre, RS, Brazil
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3
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Alessandri-Bonetti M, Costantino A, Cottone G, Carbonaro R, Cardone F, Amendola F, De Virgilio A, Robotti E, Persichetti P, Vaienti L. Efficacy of Septoplasty in Patients with Nasal Obstruction: A Systematic Review and Meta-analysis. Laryngoscope 2023; 133:3237-3246. [PMID: 37017244 DOI: 10.1002/lary.30684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 02/07/2023] [Accepted: 03/21/2023] [Indexed: 04/06/2023]
Abstract
OBJECTIVE Septoplasty is the most frequently performed ENT surgery to correct nasal septal deviation (NSD). The present study aimed to quantify the effectiveness of septoplasty with or without turbinate surgery according to NOSE questionnaire scores, with the hypothesis that it is able to clinically improve patient-reported nasal obstructive symptoms in the post-operative follow-up. METHODS An electronic search was performed on PubMed/MEDLINE, Embase, and Cochrane Library. The primary outcome was the change in NOSE score at 6 months after surgery. It was assessed with the mean difference (MD) between baseline and postoperative results. RESULTS A total of 2577 patients (males: 65.1%, 95% CI: 59.9-70.2) with a mean age of 33.3 years (n = 1456, 95% CI: 30.4-36.2) were included in this meta-analysis. The pooled baseline NOSE mean score was 68.1 (n = 2577, 95% CI: 64.3-71.9). The pooled MD in NOSE score at 6-months follow-up compared to baseline was -48.8 (n = 1730, 95% CI: -54.6 to -42.9). CONCLUSIONS Functional septoplasty with or without turbinate surgery shows a critical improvement of obstructive symptoms and quality of life according to the validated NOSE score. LEVEL OF EVIDENCE NA Laryngoscope, 133:3237-3246, 2023.
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Affiliation(s)
- Mario Alessandri-Bonetti
- Department of Reconstructive and Aesthetic Plastic Surgery, I.R.C.C.S. Istituto Galeazzi, University of Milan, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Andrea Costantino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele - Milan, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano - Milan, Italy
| | - Giuseppe Cottone
- Department of Reconstructive and Aesthetic Plastic Surgery, I.R.C.C.S. Istituto Galeazzi, University of Milan, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Riccardo Carbonaro
- Department of Reconstructive and Aesthetic Plastic Surgery, I.R.C.C.S. Istituto Galeazzi, University of Milan, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Federica Cardone
- Department of Reconstructive and Aesthetic Plastic Surgery, I.R.C.C.S. Istituto Galeazzi, University of Milan, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Francesco Amendola
- Department of Reconstructive and Aesthetic Plastic Surgery, I.R.C.C.S. Istituto Galeazzi, University of Milan, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele - Milan, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano - Milan, Italy
| | - Enrico Robotti
- Private Practice, Clinica Sant'Apollonia, Via Giovanni Motta, 37-24123, Bergamo, Italy
| | - Paolo Persichetti
- Department of Reconstructive and Aesthetic Plastic Surgery, Campus Bio-Medico University of Rome, Via Alvaro Del Portillo, 200, Rome, Italy
| | - Luca Vaienti
- Department of Reconstructive and Aesthetic Plastic Surgery, I.R.C.C.S. Istituto Galeazzi, University of Milan, Via Riccardo Galeazzi 4, 20161, Milan, Italy
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Sousa FAD, Santos M, Correia JT, Pinto AN, Meireles L, Ferreira M. Septorhinoplasty and the Late Impact on Olfactory Function: A Review and Meta-analysis. Facial Plast Surg 2023; 39:69-76. [PMID: 36384241 DOI: 10.1055/a-1979-8636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Septorhinoplasty (SRP) is one of the most commonly performed procedures worldwide. There is a recognized debate about the impact of nasal surgery on olfactory function (OF). The study's objective was to assess the effect of SRP on late postoperative OF. A comprehensive review and meta-analysis were employed to assess OF after SRP. All the integrated studies used objective instruments to quantify OF before and after surgery. A literature search was conducted, and the selected works were evaluated, computed, and finally included in a meta-analysis. The risk of bias was assessed using the NIH Guidance for Evaluating the Quality of Before-After (Pre-Post) Studies with No Control Group. Only the latest follow-up OF measurements provided by each research were considered in the analysis. The 95% confidence interval of the effect magnitude for each study was calculated to elucidate effect sizes. Eleven studies were included in the analysis. Five studies reported late OF improvement (45.5%), five reported no alteration in OF (45.5%), and only one study reported OF impairment after SRP (9%). Some works described a transitory decline in OF shortly following surgery, followed by postoperative improvement. A pooled meta-analysis showed that OF was not significantly altered after SRP (p = 0.10) in the late follow-up. SRP surgery seems to constitute a safe procedure concerning OF in the long term. According to research, OF may deteriorate temporarily after surgery with later improvement, sometimes to higher values than baseline. The anticipated evolution of OF after intervention could be discussed during the preoperative consultation for SRP.
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Affiliation(s)
- Francisco Alves de Sousa
- Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Mariline Santos
- Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - João Tavares Correia
- Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ana Nóbrega Pinto
- Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Luís Meireles
- Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Miguel Ferreira
- Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
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Characterization of Airflow Parameters in the Olfactory Fissure Zone Based on Fluid Mechanics Method. J Craniofac Surg 2023; 34:532-535. [PMID: 36217230 PMCID: PMC9944730 DOI: 10.1097/scs.0000000000009075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/24/2022] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE Airflow in the olfactory fissure region is a necessary condition for olfaction. However, due to the complex anatomy of the olfactory fissure, it is difficult to characterize the airflow in this region. At present, there are few studies on the airflow characteristics of the olfactory fissure. The aim of this study is to investigate the characteristics of objective indicators of airflow parameters in the olfactory fissure region, such as flow velocity, flow rate, pressure and flow ratio, from the perspective of biofluid mechanics. METHODS In this study, the anatomical structure of the olfactory fissure zone was reconstructed in three dimensions using raw data from 32 healthy adults and 64 sinus computed tomography scans. To study the characteristics of airflow parameter variations in the olfactory fissure region in healthy adults, 10 cross-sectional sections were established in the olfactory fissure region using computational fluid dynamics after obtaining the airflow parameter values at different anatomical positions in the olfactory fissure region. RESULTS The average flow rate of the ten cross-sections in the olfactory fissure zone was 19.22±9.74 mL/s, the average flow velocity was 0.51±0.21 m/s, the average flow percentage was 5.45%±2.52%, and the average pressure was -13.35±6.74 Pa. The percentile method was used to determine the range of reference values for P90: average flow rate of 0.02-35.87 mL/s, average flow velocity of 0.24-0.94 m/s, average flow percentage of 1.57%-9.93%, and average pressure of -30.4-4.42 Pa. Among the ten cross-sectional systems of the olfactory fissure, the median of Plane3N-Plane8N is more stable and representative. In the olfactory fissure system, the corresponding anatomical position of Plane3N-Plane8N was in the posterior region of the olfactory fissure, mainly at the junction of the anterior, middle 1/3 to the posterior middle turbinate, which was consistent with the main distribution area of the olfactory mucosa. CONCLUSION This study shows that the application of computational fluid dynamic can rapidly achieve the characterization of airflow parameters in the olfactory fissure. The airflow through the olfactory fissure in healthy adults accounted for no more than 10% of the total flow volume of the nasal cavity. The airflow parameters in the anterior region of the olfactory fissure fluctuated significantly, while those flowing through the posterior region of the olfactory fissure were more stable. This could be due to the anterior section of the middle turbinate truncating the restriction of airflow into the olfactory fissure.
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6
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Wu S, Wang P, Xie D, Jian F. Correlation analysis of flow parameters in the olfactory cleft and olfactory function. Sci Rep 2022; 12:20819. [PMID: 36460767 PMCID: PMC9716511 DOI: 10.1038/s41598-022-25282-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
The olfaction is related to flow in the olfactory cleft. However, There is a lack of studies on the relationship between flow characteristics of the olfactory cleft and olfactory function. In this study, the anatomical structure of the olfactory cleft was reconstructed in three dimensions using the raw data obtained from the CT scans of sinuses of 32 enrolled volunteers. The Sniffin' Sticks test was used to examine the olfaction. We investigated the correlation between airflow parameters and olfactory function of the olfactory cleft in healthy adults by the computational fluid dynamics method. We found that three parameters, airflow, airflow velocity, and airflow ratio, were highly positively correlated with olfactory function. The mean pressure was not correlated with the olfactory function. Furthermore, there is the strongest correlation between air flow through the olfactory cleft and olfactory function. The correlation between the mean velocity in the anterior olfactory cleft region and olfaction was relatively poor, while the airflow velocity at the posterior olfactory cleft region was enhanced gradually. The correlation between the airflow ratio and olfaction was optimal in the initial position of superior turbinate. The flow parameters in the posterior olfactory cleft area were more stable.
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Affiliation(s)
- Shuo Wu
- grid.12981.330000 0001 2360 039XE.N.T. Department, The 3rd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Peiji Wang
- grid.12981.330000 0001 2360 039XSchool of Physics and Astronomy, Sun Yat-Sen University, Zhuhai, People’s Republic of China
| | - Dielai Xie
- grid.12981.330000 0001 2360 039XRadiology Department, The 3rd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Feitong Jian
- grid.12981.330000 0001 2360 039XE.N.T. Department, The 3rd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
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Liu M, Liu J, Weitzel EK, Chen PG. The predictive utility of the 22-item sino-nasal outcome test (SNOT-22): A scoping review. Int Forum Allergy Rhinol 2021; 12:83-102. [PMID: 34585521 DOI: 10.1002/alr.22888] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/04/2021] [Accepted: 08/04/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND The 22-item sino-nasal outcome test (SNOT-22) is a widely used and powerful patient-reported outcomes measure for chronic rhinosinusitis (CRS). More recently; however, the SNOT-22 has been evaluated as a predictive tool for multiple conditions. The objective of this scoping review is to investigate the extent to which SNOT-22 is used in this manner and present this information in a way useful for clinicians. METHODS A systematic search of PubMed, Scopus, Cochrane Library, and Web of Science was performed. Studies that evaluated SNOT-22s predictive utility were considered for eligibility in this scoping review. RESULTS A total of 39 studies met eligibility. The SNOT-22 was found to be used as a predictive tool in three broad categories: (1) to predict a diagnosis, (2) to predict an outcome of an intervention, and (3) to predict a patient treatment preference. Thirteen studies were included in the diagnosis category, which made up ten different individual predictions. Twenty-four studies were included in the outcomes category and investigated 17 different individual predictions. Finally, two studies were included in the patient preferences category, which together made one prediction. CONCLUSIONS The SNOT-22 is a versatile tool that has the potential to be used in predicting various diagnoses, outcomes, and patient preferences. However, care must be taken in applying these predictions to clinical practice, as further research must be done in validating these predictions based on SNOT-22 responses.
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Affiliation(s)
- Matthew Liu
- Dell Medical School, the University of Texas at Austin, Austin, Texas, USA
| | - Jeremy Liu
- John A. Burns School of Medicine, University of Hawaii Manoa, Honolulu, Hawaii, USA
| | - Erik K Weitzel
- 59th MDW/SGO Chief of Operational Medicine, JBSA, Lackland AFB, Texas, USA
| | - Philip G Chen
- Department of Otolaryngology, Head and Neck Surgery, University of Texas Health San Antonio, San Antonio, Texas, USA
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Pfaff MJ, Bertrand AA, Lipman KJ, Shah A, Nolan I, Krishna V, Patel H, Roostaeian J, Lee JC. The Effect of Functional Nasal Surgery on Olfactory Function. Plast Reconstr Surg 2021; 147:707-718. [PMID: 33620941 DOI: 10.1097/prs.0000000000007667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Functional and aesthetic nasal operations are some of the most common plastic surgery procedures performed in the United States. The purpose of the study was to evaluate the effects of septoplasty, septorhinoplasty, and rhinoplasty procedures on postoperative olfactory function and their relationship to nasal airflow and quality of life. METHODS A systematic review and meta-analysis was performed evaluating olfactory function following nasal surgery. Preoperative and postoperative values for olfaction, nasal airflow, and quality of life/nasal symptoms were analyzed. The effect size was calculated from each study and used for meta-analysis. As studies evaluated patients at different points in the postoperative period, the latest time point reported by each study was used in the meta-analysis. The 95 percent confidence interval of the effect size was calculated for each study. Study quality was assessed using the Jadad and Methodological Index for Nonrandomized Studies instruments. All included studies were Level of Evidence II. RESULTS There were 25 included studies. Following nasal surgery, patients experienced significant improvements in olfaction (p < 0.001), nasal airflow (p < 0.001), and quality of life/nasal symptoms (p < 0.001). Patients often experienced a transient decrease in olfaction immediately after surgery, followed by improvement postoperatively. Preoperative olfactory dysfunction rates were low and postoperative dysfunction was equally low. Olfaction improvement was directly correlated with improvement in nasal airflow and quality of life. CONCLUSIONS Functional and aesthetic nasal operations appear to significantly improve olfaction, which is directly correlated with nasal airflow. Some studies report a transient worsening of these measures in the immediate postoperative period, which subsequently improved at later time points.
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Affiliation(s)
- Miles J Pfaff
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Anthony A Bertrand
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Kelsey J Lipman
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Aloukika Shah
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Ian Nolan
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Vikram Krishna
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Harsh Patel
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Jason Roostaeian
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
| | - Justine C Lee
- From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine
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Kang XR, Chen B, Chen YS, Yi B, Yan X, Jiang C, Wang S, Lu L, Shi R. A prediction modeling based on SNOT-22 score for endoscopic nasal septoplasty: a retrospective study. PeerJ 2020; 8:e9890. [PMID: 32974101 PMCID: PMC7489239 DOI: 10.7717/peerj.9890] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/17/2020] [Indexed: 12/15/2022] Open
Abstract
Background To create a nomogram prediction model for the efficacy of endoscopic nasal septoplasty, and the likelihood of patient benefiting from the operation. Methods A retrospective analysis of 155 patients with nasal septum deviation (NSD) was performed to develop a predictive model for the efficacy of endoscopic nasal septoplasty. Quality of life (QoL) data was collected before and after surgery using Sinonasal Outcome Test-22 (SNOT-22) scores to evaluate the surgical outcome. An effective surgical outcome was defined as a SNOT-22 score change ≥ 9 points after surgery. Multivariate logistic regression analysis was then used to establish a predictive model for the NSD treatment. The predictive quality and clinical utility of the predictive model were assessed by C-index, calibration plots, and decision curve analysis. Results The identified risk factors for inclusion in the predictive model were included. The model had a good predictive power, with a AUC of 0.920 in the training group and a C index of 0.911 in the overall sample. Decision curve analysis revealed that the prediction model had a good clinical applicability. Conclusions Our prediction model is efficient in predicting the efficacy of endoscopic surgery for NSD through evaluation of factors including: history of nasal surgery, preoperative SNOT-22 score, sinusitis, middle turbinate plasty, BMI, smoking, follow-up time, seasonal allergies, and advanced age. Therefore, it can be cost-effective for individualized preoperative assessment.
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Affiliation(s)
- Xue-Ran Kang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai ninth people's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China
| | - Bin Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai ninth people's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China
| | - Yi-Sheng Chen
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Yi
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai ninth people's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China
| | - Xiaojun Yan
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai ninth people's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China
| | - Chenyan Jiang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai ninth people's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China
| | - Shulun Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai ninth people's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China
| | - Lixing Lu
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai ninth people's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China
| | - Runjie Shi
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai ninth people's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China
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Valsamidis K, Printza A, Constantinidis J, Triaridis S. The Impact of Olfactory Dysfunction on the Psychological Status and Quality of Life of Patients with Nasal Obstruction and Septal Deviation. Int Arch Otorhinolaryngol 2020; 24:e237-e246. [PMID: 32296471 PMCID: PMC7153923 DOI: 10.1055/s-0040-1701269] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 12/03/2019] [Indexed: 01/25/2023] Open
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.
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Affiliation(s)
- Konstantinos Valsamidis
- 1st Otolaryngology Department, Medical school, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
| | - Athanasia Printza
- 1st Otolaryngology Department, Medical school, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
| | - Jannis Constantinidis
- 1st Otolaryngology Department, Medical school, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
| | - Stefanos Triaridis
- 1st Otolaryngology Department, Medical school, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
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Valsamidis K, Printza A, Titelis K, Constantinidis J, Triaridis S. Olfaction and quality of life in patients with nasal septal deviation treated with septoplasty. Am J Otolaryngol 2019; 40:747-754. [PMID: 31345588 DOI: 10.1016/j.amjoto.2019.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 07/15/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Patients with septal deviation-induced nasal obstruction may experience olfactory impairment. This study aimed to evaluate septoplasty-related changes in olfactory function and their effect on patients' quality of life (QoL). METHODS Prospective study of sixty patients with nasal obstruction and septal deviation and 25 healthy controls. Objective measurements were performed for the evaluation of nasal patency and "Sniffin' sticks" tests were used for quantitative assessment of lateralized and bilateral olfactory performance. All participants self-assessed their smell using a visual analog scale and completed validated questionnaires for nasal obstruction (Nasal Obstruction Symptom Evaluation: NOSE), for nasal symptoms QoL (SinoNasal Outcome Test-22: SNOT-22), for olfaction-associated QoL (Questionnaire of Olfactory Deficits: QOD) preoperatively and six months after septoplasty and reported personal benefit after surgery (Glasgow Benefit Inventory: GBI), six months postoperatively. RESULTS Smell was significantly compromised due to septal deviation especially in the more obstructed nasal cavity side. Smell improved significantly after septoplasty (subjective report and olfactory measurements), along with increased nasal patency. Increased nasal cavity volume was significantly correlated with olfactory thresholds but not with suprathreshold measurements. Subjective hyposmia and lateralized olfaction were significantly reduced postoperatively. Postoperatively, normosmic patients reported higher personal benefit from surgery than patients with olfactory disorders. The patients' QoL improved significantly, but it remained lower than the controls' group. Olfaction-associated QoL was not significantly different between patients and controls before and after septoplasty. CONCLUSION Septoplasty leads to improvement in smell perception, and patients with improved smell report greater personal benefit from septoplasty than patients with remaining olfactory deficits.
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Affiliation(s)
- Konstantinos Valsamidis
- 1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Athanasia Printza
- 1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
| | - Konstantinos Titelis
- Otolaryngology Department, General Hospital Georgios Gennimatas, Ethnikis Amynis 41, 54635 Thessaloniki, Greece.
| | - Jannis Constantinidis
- 1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
| | - Stefanos Triaridis
- 1st Otolaryngology Department, Medical Dept, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
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