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CC BY 4.0 · Facial Plast Surg
DOI: 10.1055/a-2535-0153
DOI: 10.1055/a-2535-0153
Original Research
The Effectiveness of Functional Septorhinoplasty in Improving COVID-19-related Olfactory Dysfunction
Abstract
Long-Term COVID-19-related olfactory dysfunction (C19OD) remains a significant challenge with no established treatment providing meaningful improvement. This study aimed to assess the efficacy of functional septorhinoplasty (fSRP) in improving olfactory dysfunction in patients with persistent C19OD compared to a control group undergoing olfactory training (OT). In this prospective study patients with persistent C19OD undergoing fSRP were enrolled while those declining surgery continued with OT as the control group. Patients were followed for six months with olfactory function assessed using Sniffin' Sticks (S'S) and nasal airflow evaluated through peak nasal inspiratory flow (PNIF) and acoustic rhinometry (AR). Among the participants 12 underwent fSRP while 13 were in the control group. Significant improvements (p < 0.05) in all S'S scores were observed in the fSRP group but not in the control group. TDI scores improved above the minimal clinically important difference only in the fSRP group. Strong correlations were found between olfactory scores and nasal measurements. Comparison of olfactory threshold gains between groups revealed a statistically significant benefit in the fSRP group. These findings suggest that fSRP can significantly improve persistent C19OD providing a notable olfactory threshold gain compared to OT.
Keywords
olfaction - olfactory dysfunction - post-infectious olfactory dysfunction - COVID-19 - septorhinoplastyPublikationsverlauf
Accepted Manuscript online:
10. Februar 2025
Artikel online veröffentlicht:
24. Februar 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Medical Publishers, Inc.
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References
- 1 Andrews PJ, Pendolino AL, Ottaviano G. et al. Olfactory and taste dysfunction among mild-to-moderate symptomatic COVID-19 positive health care workers: an international survey. Laryngoscope Investig Otolaryngol 2020; 5 (06) 1019-1028
- 2 Bordin A, Mucignat-Caretta C, Gaudioso P. et al. Comparison of self-reported symptoms and psychophysical tests in coronavirus disease 2019 (COVID-19) subjects experiencing long-term olfactory dysfunction: a 6-month follow-up study. Int Forum Allergy Rhinol 2021; 11 (11) 1592-1595
- 3 Pendolino AL, Tan HQM, Choi D, Ottaviano G, Andrews PJ. Long-term quality-of-life impairment in patients with more than 1-year COVID-19-related olfactory dysfunction. Int Forum Allergy Rhinol 2023; 13 (02) 160-164
- 4 Pendolino AL, Ottaviano G, Navaratnam AV, Scarpa B, Andrews PJ. Clinical factors influencing olfactory performance in patients with persistent COVID-19 smell loss longer than 1 year. Laryngoscope Investig Otolaryngol 2023; 8 (06) 1449-1458
- 5 Patel ZM, Holbrook EH, Turner JH. et al. International consensus statement on allergy and rhinology: olfaction. Int Forum Allergy Rhinol 2022; 12 (04) 327-680
- 6 Boscolo-Rizzo P, Hummel T, Spinato G. et al. Olfactory and gustatory function 3 years after mild COVID-19—a cohort psychophysical study. JAMA Otolaryngol Head Neck Surg 2024; 150 (01) 79-81
- 7 Liang F, Wang Y. COVID-19 anosmia: high prevalence, plural neuropathogenic mechanisms, and scarce neurotropism of SARS-CoV-2?. Viruses 2021; 13 (11) 2225
- 8 Khan M, Yoo SJ, Clijsters M. et al. Visualizing in deceased COVID-19 patients how SARS-CoV-2 attacks the respiratory and olfactory mucosae but spares the olfactory bulb. Cell 2021; 184 (24) 5932-5949.e15
- 9 Pfaff MJ, Bertrand AA, Lipman KJ. et al. The effect of functional nasal surgery on olfactory function. Plast Reconstr Surg 2021; 147 (03) 707-718
- 10 Whitcroft KL, Mancini L, Yousry T, Hummel T, Andrews PJ. Functional septorhinoplasty alters brain structure and function: neuroanatomical correlates of olfactory dysfunction. Front Allergy 2023; 4: 1079945
- 11 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 (05) 747-754
- 12 Fyrmpas G, Tsalighopoulos M, Constantinidis J. Lateralized olfactory difference in patients with a nasal septal deviation before and after septoplasty*. Hippokratia 2012; 16 (02) 166-169
- 13 Pfaar O, Hüttenbrink KB, Hummel T. Assessment of olfactory function after septoplasty: a longitudinal study. Rhinology 2004; 42 (04) 195-199
- 14 Altundag A, Salihoglu M, Tekeli H, Saglam M, Cayonu M, Hummel T. Lateralized differences in olfactory function and olfactory bulb volume relate to nasal septum deviation. J Craniofac Surg 2014; 25 (02) 359-362
- 15 Mackers P, Rojas-Lechuga MJ, Langdon C, Noguà S A, Mullol J, Alobid I. Septoplasty and/or inferior turbinoplasty produce significant improvements of the sense of smell. Rhinology 2023; 61 (05) 421-431
- 16 Elbistanli MS, Koçak HE, Çelik M. et al. Significance of medial osteotomy on the olfactory function in patients who underwent septorhinoplasty. J Craniofac Surg 2019; 30 (02) e106-e109
- 17 Dengiz R, Haytoğlu S, Görgülü O, Doğru M, Arıkan OK. Effect of septorhinoplasty on olfactory function: assessment using the brief smell identification test. Turk Arch Otorhinolaryngol 2015; 53 (01) 4-9
- 18 Dalgic A, Is A, Dinc ME, Ulusoy S, Avinçsal MO, Kulekci M. The effects of nasal packing and transseptal suturing after septoplasty on olfactory function, patient comfort, and mucociliary clearance. J Craniofac Surg 2016; 27 (05) e487-e490
- 19 Kilicaslan A, Acar GO, Tekin M, Ozdamar OI. Assessment the long-term effects of septoplasty surgery on olfactory function. Acta Otolaryngol 2016; 136 (10) 1079-1084
- 20 Haytoğlu S, Dengiz R, Muluk NB, Kuran G, Arikan OK. Effects of septoplasty on olfactory function evaluated by the Brief Smell Identification Test: a study of 116 patients. Ear Nose Throat J 2017; 96 (10-11): 433-438
- 21 Ulusoy S, Dinç ME, Dalğıç A, Dizdar D, Avınçsal MO, Külekçi M. Effects of spreader grafts on olfactory function in septorhinoplasty. Aesthetic Plast Surg 2016; 40 (01) 106-113
- 22 Shemshadi H, Azimian M, Onsori MA, Azizabadi Farahani M. Olfactory function following open rhinoplasty: a 6-month follow-up study. BMC Ear Nose Throat Disord 2008; 8: 6
- 23 Choi YS, Ryu YJ, Rhee J. et al. Clinical implications of septal deviation in lateralized olfaction. Clin Exp Otorhinolaryngol 2016; 9 (01) 39-43
- 24 Gupta N, Singh PP, Bagla RK. Will septal correction surgery for deviated nasal septum improve the sense of smell? A prospective study. Surg Res Pract 2015; 2015: 496542
- 25 Stevens CN, Stevens MH. Quantitative effects of nasal surgery on olfaction. Am J Otolaryngol 1985; 6 (04) 264-267
- 26 Randhawa PS, Watson N, Lechner M, Ritchie L, Choudhury N, Andrews PJ. The outcome of septorhinoplasty surgery on olfactory function. Clin Otolaryngol 2016; 41 (01) 15-20
- 27 Gillman GS, Bakeman AE, Soose RJ. et al. Will nasal airway surgery improve my sense of smell? A prospective observational study. Int Forum Allergy Rhinol 2023; 13 (08) 1511-1517
- 28 Zhao K, Scherer PW, Hajiloo SA, Dalton P. Effect of anatomy on human nasal air flow and odorant transport patterns: implications for olfaction. Chem Senses 2004; 29 (05) 365-379
- 29 Pendolino AL, Randhawa P, Unadkat S, Andrews PJ. Septoplasty for nasal obstruction. Lancet 2020; 395 (10223): 493
- 30 Sousa FA, 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 (01) 69-76
- 31 O'Byrne L, Webster KE, MacKeith S, Philpott C, Hopkins C, Burton MJ. Interventions for the treatment of persistent post-COVID-19 olfactory dysfunction. Cochrane Database Syst Rev 2022; 9 (09) CD013876
- 32 Oleszkiewicz A, Schriever VA, Croy I, Hähner A, Hummel T. Updated Sniffin' Sticks normative data based on an extended sample of 9139 subjects. Eur Arch Otorhinolaryngol 2019; 276 (03) 719-728
- 33 Gudziol V, Lötsch J, Hähner A, Zahnert T, Hummel T. Clinical significance of results from olfactory testing. Laryngoscope 2006; 116 (10) 1858-1863
- 34 Ottaviano G, Pendolino AL, Nardello E. et al. Peak nasal inspiratory flow measurement and visual analogue scale in a large adult population. Clin Otolaryngol 2019; 44 (04) 541-548
- 35 Ottaviano G, Scadding GK, Scarpa B, Accordi D, Staffieri A, Lund VJ. Unilateral peak nasal inspiratory flow, normal values in adult population. Rhinology 2012; 50 (04) 386-392
- 36 Ottaviano G, Fokkens WJ. Measurements of nasal airflow and patency: a critical review with emphasis on the use of peak nasal inspiratory flow in daily practice. Allergy 2016; 71 (02) 162-174
- 37 DeConde AS, Mace JC, Bodner T. et al. SNOT-22 quality of life domains differentially predict treatment modality selection in chronic rhinosinusitis. Int Forum Allergy Rhinol 2014; 4 (12) 972-979
- 38 Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg 2004; 130 (02) 157-163
- 39 Ottaviano G, Scadding GK, Coles S, Lund VJ. Peak nasal inspiratory flow; normal range in adult population. Rhinology 2006; 44 (01) 32-35
- 40 Straszek SP, Schlünssen V, Sigsgaard T, Pedersen OF. Reference values for acoustic rhinometry in decongested school children and adults: the most sensitive measurement for change in nasal patency. Rhinology 2007; 45 (01) 36-39
- 41 Bowling A, Bond M, Jenkinson C, Lamping DL. Short Form 36 (SF-36) Health Survey questionnaire: which normative data should be used? Comparisons between the norms provided by the Omnibus Survey in Britain, the Health Survey for England and the Oxford Healthy Life Survey. J Public Health Med 1999; 21 (03) 255-270
- 42 Hopkins C, Gillett S, Slack R, Lund VJ, Browne JP. Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol 2009; 34 (05) 447-454
- 43 Shastri K, Gao Y, Davis SJ. et al. Normative values of the nasal obstruction symptom evaluation scale. Facial Plast Surg Aesthet Med 2023; 25 (01) 35-39
- 44 Hornung DE, Leopold DA. Relationship between uninasal anatomy and uninasal olfactory ability. Arch Otolaryngol Head Neck Surg 1999; 125 (01) 53-58
- 45 Hedner M, Larsson M, Arnold N, Zucco GM, Hummel T. Cognitive factors in odor detection, odor discrimination, and odor identification tasks. J Clin Exp Neuropsychol 2010; 32 (10) 1062-1067
- 46 Damm M, Eckel HE, Jungehülsing M, Hummel T. Olfactory changes at threshold and suprathreshold levels following septoplasty with partial inferior turbinectomy. Ann Otol Rhinol Laryngol 2003; 112 (01) 91-97
- 47 Aydoğdu I, Atar Y, Aydoğdu Z. et al. Comparison of olfactory function and quality of life with different surgical techniques for nasal septum deviation. J Craniofac Surg 2019; 30 (02) 433-436
- 48 Türk B, Akpinar M, Altundağ A, Kirik MO, Ünsal Ö, Coşkun BU. The effect of external approach septoplasty on olfactory function. J Craniofac Surg 2017; 28 (07) 1675-1678
- 49 Berkiten G, Kumral TL, Saltürk Z. et al. Effect of deviated nasal septum type on nasal mucociliary clearance, olfactory function, quality of life, and efficiency of nasal surgery. J Craniofac Surg 2016; 27 (05) 1151-1155
- 50 Philpott CM, Rimal D, Tassone P, Prinsley PR, Premachandra DJ. A study of olfactory testing in patients with rhinological pathology in the ENT clinic. Rhinology 2008; 46 (01) 34-39
- 51 Leopold DA. The relationship between nasal anatomy and human olfaction. Laryngoscope 1988; 98 (11) 1232-1238
- 52 Damm M, Vent J, Schmidt M. et al. Intranasal volume and olfactory function. Chem Senses 2002; 27 (09) 831-839
- 53 Hornung DE, Smith DJ, Kurtz DB, White T, Leopold DA. Effect of nasal dilators on nasal structures, sniffing strategies, and olfactory ability. Rhinology 2001; 39 (02) 84-87
- 54 Unadkat SN, Pendolino AL, Auer D. et al. The evidence base for the benefits of functional septorhinoplasty and its future post COVID-19. Facial Plast Surg 2021; 37 (05) 625-631
- 55 Ramprasad VH, Frank-Ito DO. A computational analysis of nasal vestibule morphologic variabilities on nasal function. J Biomech 2016; 49 (03) 450-457
- 56 Sicard RM, Frank-Ito DO. Role of nasal vestibule morphological variations on olfactory airflow dynamics. Clin Biomech (Bristol) 2021; 82: 105282
- 57 Whitcroft KL, Altundag A, Balungwe P. et al. Position paper on olfactory dysfunction: 2023. Rhinology 2023; 61 (33) 1-108
- 58 Hwang SH, Kim SW, Basurrah MA, Kim DH. The efficacy of olfactory training as a treatment for olfactory disorders caused by coronavirus disease-2019: a systematic review and meta-analysis. Am J Rhinol Allergy 2023; 37 (04) 495-501