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European Archives of Oto-Rhino-Laryngology
Published in: European Archives of Oto-Rhino-Laryngology 2/2021

Open Access 01-02-2021 | Smelling Disorder | Rhinology

Ortho- and retronasal olfactory performance in rhinosurgical procedures: a longitudinal comparative study

Authors: Gerold Besser, David T. Liu, Gunjan Sharma, Tina J. Bartosik, Sebastian Kaphle, Max Enßlin, Bertold Renner, Christian A. Mueller

Published in: European Archives of Oto-Rhino-Laryngology | Issue 2/2021

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Abstract

Purpose

Testing olfaction should be an integral part of a clinical work-up in rhinosurgical procedures. Importantly, intact olfactory experience also includes retronasally perceived odors (retronasal olfaction). This study aimed at comprehensively assessing olfaction in patients undergoing rhinosurgical procedures in a comparative manner and evaluating relations to patient-reported outcome measurements (PROMs).

Methods

Each nostril odor threshold and discrimination, and birhinal identification were tested using Sniffin’ Sticks in 14 subjects assigned for septoplasty (SP), 21 for septorhinoplasty (SRP), and 30 for endoscopic sinus surgery (ESS). The 27-Candy-Smell-Test was used to quantify retronasal abilities. Tests were repeated 3 months after surgery.

Results

Olfactory dysfunction was preoperatively present in 21% of SP, in 47.6% of SRP, and in 80% of ESS patients. Odor threshold side differences were most frequently found in SRP. Frequently, SRP and ESS patients showed severely impaired retronasal olfaction. Half of included subjects re-visited after 3 months, but olfactory function did not improve overall and rarely on an individual basis to a meaningful extent. Subjective ratings on nasal patency and PROMs were not associated with olfaction nor with changes in olfactory scores.

Conclusion

Olfactory function can decisively be impaired a priori not only in patients awaiting sinus surgery, but also in those assigned for functional septorhinoplasty. This impairment may not improve in the short term, which has to be taken into account in patient counseling. This study adds to the current literature on olfaction in rhinosurgery with the extension of retronasal testing.
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Metadata
Title
Ortho- and retronasal olfactory performance in rhinosurgical procedures: a longitudinal comparative study
Authors
Gerold Besser
David T. Liu
Gunjan Sharma
Tina J. Bartosik
Sebastian Kaphle
Max Enßlin
Bertold Renner
Christian A. Mueller
Publication date
01-02-2021
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 2/2021
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-020-06300-4

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