Facial Plast Surg 2023; 39(01): 069-076
DOI: 10.1055/a-1979-8636
Original Article

Septorhinoplasty and the Late Impact on Olfactory Function: A Review and Meta-analysis

1   Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
,
Mariline Santos
1   Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
,
João Tavares Correia
1   Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
,
Ana Nóbrega Pinto
1   Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
,
Luís Meireles
1   Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
,
Miguel Ferreira
1   Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
› Institutsangaben

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.



Publikationsverlauf

Accepted Manuscript online:
16. November 2022

Artikel online veröffentlicht:
27. Januar 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 International Society of Aesthetic Plastic Surgery. International survey on aesthetic/cosmetic procedures performed in 2019. Accessed September 25, 2022 at: https://www.isaps.org/wp-content/uploads/2021/12/2020-Press-release-final.pdf
  • 2 Kokubo LCP, Carvalho TBO, Fornazieri MA, Gomes EMC, Alves CMF, Sampaio ALL. Effects of septorhinoplasty on smell perception. Eur Arch Otorhinolaryngol 2019; 276 (04) 1247-1250
  • 3 Pfaar O, Hüttenbrink KB, Hummel T. Assessment of olfactory function after septoplasty: a longitudinal study. Rhinology 2004; 42 (04) 195-199
  • 4 Temmel AFP, Quint C, Schickinger-Fischer B, Klimek L, Stoller E, Hummel T. Characteristics of olfactory disorders in relation to major causes of olfactory loss. Arch Otolaryngol Head Neck Surg 2002; 128 (06) 635-641
  • 5 Miwa T, Furukawa M, Tsukatani T, Costanzo RM, DiNardo LJ, Reiter ER. Impact of olfactory impairment on quality of life and disability. Arch Otolaryngol Head Neck Surg 2001; 127 (05) 497-503
  • 6 Deems DA, Doty RL, Settle RG. et al. Smell and taste disorders, a study of 750 patients from the University of Pennsylvania Smell and Taste Center. Arch Otolaryngol Head Neck Surg 1991; 117 (05) 519-528
  • 7 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
  • 8 Tutar B, Ekincioglu E, Karaketir S. et al. The impact of platelet-rich fibrin (PRF) on olfactory function and pain after septoplasty operations. Eur Arch Otorhinolaryngol 2020; 277 (04) 1115-1120
  • 9 Miyake MM, Miyamura BV, Grunewald RE. et al. Avaliação do olfato de pacientes submetidos à septoplastia e rinoseptoplastia no Hospital Central Santa Casa de São Paulo. Accessed September 26, 2022 at: http://arquivosmedicos.fcmsantacasasp.edu.br/index.php/AMSCSP/article/view/99
  • 10 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
  • 11 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
  • 12 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
  • 13 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
  • 14 Hummel T, Hüttenbrink KB. Olfactory dysfunction due to nasal sinus disease. Causes, consequences, epidemiology, and therapy [in German]. HNO 2005; 53 (Suppl. 01) S26-S32
  • 15 Knight LD, Presnell SE. Death by sewer gas: case report of a double fatality and review of the literature. Am J Forensic Med Pathol 2005; 26 (02) 181-185
  • 16 Menon C, Westervelt HJ, Jahn DR, Dressel JA, O'Bryant SE. Normative performance on the Brief Smell Identification Test (BSIT) in a multi-ethnic bilingual cohort: a Project FRONTIER study. Clin Neuropsychol 2013; 27 (06) 946-961
  • 17 Veyseller B, Ozucer B, Karaaltin AB. et al. Connecticut (CCCRC) olfactory test: normative values in 426 healthy volunteers. Indian J Otolaryngol Head Neck Surg 2014; 66 (01) 31-34
  • 18 Rumeau C, Nguyen DT, Jankowski R. How to assess olfactory performance with the Sniffin' Sticks test(®). Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133 (03) 203-206
  • 19 Champion R. Anosmia associated with corrective rhinoplasty. Br J Plast Surg 1966; 19 (02) 182-185
  • 20 National Heart, Lung, and Blood Institute. NIH Study Quality Assessment Tools: Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group. Bethesda: NIH. Accessed September 25, 2022 at: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools
  • 21 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
  • 22 Murad MH, Wang Z, Chu H, Lin L. When continuous outcomes are measured using different scales: guide for meta-analysis and interpretation. BMJ 2019; 364: k4817
  • 23 Higgins JPT, Thomas J, Chandler J. et al, eds. Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane, 2022. Accessed September 25, 2022 at: www.training.cochrane.org/handbook
  • 24 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
  • 25 Ulusoy S, Dinç ME, Dalğıç A, Dizdar D, Avınçsal MÖ, Külekçi M. Effects of Spreader Grafts on Olfactory Function in Septorhinoplasty. Aesthetic Plast Surg 2016; 40 (01) 106-113
  • 26 Briner HR, Simmen D, Jones N. Impaired sense of smell in patients with nasal surgery. Clin Otolaryngol Allied Sci 2003; 28 (05) 417-419
  • 27 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 (01) 6
  • 28 Razmpa E, Saedi B, Safavi A, Mohammadi S. Olfactory function after nasal plastic surgery. B-ENT 2013; 9 (04) 269-275
  • 29 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
  • 30 Türk B, Akpinar M, Altundağ A, Kirik MÖ, Ünsal Ö, Coşkun BU. The effect of external approach septoplasty on olfactory function. J Craniofac Surg 2017; 28 (07) 1675-1678
  • 31 Mohebbi A, Yarahmadi A. Association between satisfaction with nasal appearance and olfactory function in patients undergoing septorhinoplasty surgery. Arch Iran Med 2022; 25 (05) 314-318
  • 32 Tufanaru C, Munn Z, Stephenson M, Aromataris E. Fixed or random effects meta-analysis? Common methodological issues in systematic reviews of effectiveness. Int J Evid-Based Healthc 2015; 13 (03) 196-207
  • 33 Sousa FA, Machado AS, da Costa JC. et al. Tailored Approach for Persistent Olfactory Dysfunction After SARS-CoV-2 Infection: A Pilot Study [published online ahead of print, 2022 Jul 12]. DOI: 10.1177/00034894221111093.
  • 34 Grabosky A, Mackers P, Langdon C, Alobid I. Change in olfactory function after septoplasty. A systematic review and meta-analysis. Rhinology 2021; 59 (02) 144-150
  • 35 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
  • 36 Dalgic A, Is A, Dinc ME, Ulusoy S, Avinçsal MÖ, 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
  • 37 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
  • 38 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
  • 39 Svider PF, Mauro AC, Eloy JA, Setzen M, Carron MA, Folbe AJ. Malodorous consequences: what comprises negligence in anosmia litigation?. Int Forum Allergy Rhinol 2014; 4 (03) 216-222
  • 40 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
  • 41 Tsang CLN, Nguyen T, Sivesind T, Cervin A. Long-term patient-related outcome measures of septoplasty: a systematic review. Eur Arch Otorhinolaryngol 2018; 275 (05) 1039-1048
  • 42 Zarabanda D, Vukkadala N, Phillips KM. et al. The effect of povidone-iodine nasal spray on nasopharyngeal SARS-CoV-2 viral load: a randomized control trial. Laryngoscope 2022; 132 (11) 2089-2095
  • 43 Elsersy HE, Zahran MAH, Elbakry AE. et al. Combined nasal, oropharyngeal povidone iodine plus glycyrrhizic acid sprays, accelerate clinical and laboratory recovery and reduces household transmission of SARS-CoV-2: a randomized placebo-controlled clinical trial. Front Med (Lausanne) 2022; 9: 863917