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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; 61:421-431. [PMID: 37475674 DOI: 10.4193/rhin22.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
BACKGROUND Patients with septal deviation and/or turbinal hypertrophy may experience olfactory disfunction (OD). The aim of this study was to analyse the effect of septoplasty and/or turbinoplasty on both lateralized and bilateral olfactory function. METHODOLOGY Prospective study of 47 patients with nasal obstruction secondary to septal deviation and/or turbinal hypertrophy and 20 healthy controls. The Barcelona Olfactory test (BOT-8), a new supraliminal orthonasal subjective olfactometry, was applied 3 times in a row (in each nostril separately and in both simultaneously). The 8 items were applied randomly to minimize the possible risk of learning. The test has not established the minimal clinically important difference (MCID). Anterior rhinomanometry and acoustic rhinometry were performed. All participants self-assessed smell loss and nasal obstruction using a visual analogue scale (VAS) and completed questionnaires for nasal obstruction (Nasal Obstruction Symptom Evaluation, NOSE) and for quality of life (QoL), using disease-specific (SinoNasal Outcome Test-22, SNOT-22) and generic (Short Form-12 Health Survey, SF-12) questionnaires. Nasal measurements and questionnaires were performed preoperatively and 12 months after surgery. RESULTS Before surgery, patients reported worse VAS on smell loss and on nasal obstruction compared to controls. Patients scored lower BOT-8 than controls. Lateralized preoperative olfactory function showed that all BOT-8 characteristics were lower at the narrow side than the wider one. Smell function and QoL improved significantly one year after surgery. CONCLUSIONS Nasal septal deviation and turbinal hypertrophy lead to an olfactory impairment on the obstructed nostril. Nasal surgery provides a positive outcome on olfactory function, as well as on subjective and objective outcomes.
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Affiliation(s)
- P Mackers
- Rhinology and Skull Base Units, Smell Clinic, Otorhinolaryngology Department Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; and Otorhinolaryngology Department, Hospital del Mar, Barcelona, Catalonia, Spain
| | - M J Rojas-Lechuga
- Rhinology and Skull Base Units, Smell Clinic, Otorhinolaryngology Department Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain
| | - C Langdon
- Rhinology and Skull Base Units, Smell Clinic, Otorhinolaryngology Department Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; and Otorhinolaryngology Department, Hospital Sant Joan de Deu, Barcelona, Catalonia, Spain
| | - A Noguà S
- Rhinology and Skull Base Units, Smell Clinic, Otorhinolaryngology Department Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; and Otorhinolaryngology Department Consorci Sanitari Alt Penedes Garraf. Barcelona, Catalonia, Spain
| | - J Mullol
- Rhinology and Skull Base Units, Smell Clinic, Otorhinolaryngology Department Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; and Clinical and Experimental Respiratory Immunollergy, IDIBAPS, Barcelona, Catalonia, Spain; and CIBER of Respiratory Diseases (CIBERES), Health Institute Carlos III, Spain
| | - I Alobid
- Rhinology and Skull Base Units, Smell Clinic, Otorhinolaryngology Department Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Catalonia, Spain; and Clinical and Experimental Respiratory Immunollergy, IDIBAPS, Barcelona, Catalonia, Spain; and CIBER of Respiratory Diseases (CIBERES), Health Institute Carlos III, Spain; and Unidad Alergo Rino, Centro Medico Teknon, Barcelona, Catalonia, Spain
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Rojas-Lechuga MJ, Ceballos JC, Valls-Mateus M, Mackers P, Izquierdo-Domínguez A, López-Chacón M, Langdon C, Mariño-Sánchez F, Valero J, Mullol J, Alobid I. Barcelona Olfactory Test - 8: validation of a new test on Spanish population during COVID-19 pandemic. J Investig Allergol Clin Immunol 2022; 32:291-298. [PMID: 35532333 DOI: 10.18176/jiaci.0824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND In daily clinical practice, most smell tests are difficult to implement due to their long duration. The aim of the present study was to develop and validate a short, easy to perform, and reusable smell test to be implemented during COVID-19 pandemic. METHODS 120 healthy adults and 195 patients with self-reported olfactory dysfunction (OD) were included. Barcelona Olfactory Test (BOT-8) was used for detection, memory/recognition, and forced-choice identification. In addition, rose threshold test and VAS was performed. The Smell Diskettes Olfaction test (SDOT) was used for correlation in healthy volunteers, and UPSITTM for patients with OD to stablish an anosmia and hyposmia cut-off point. Considering COVID-19 pandemic disposable cotton swabs with odorants were compared with the original test. RESULTS In healthy population, BOT-8 mean scores for detection was 100%, memory/recognition was 94.5% (SD=1.07), and identification was 89.6% (SD=0.86). In OD patients was 86% (SD=32.8), 73.2% (SD=37.9) and 77.1% (SD=34.2), respectively. BOT-8 demonstrated good test-retest reliability with a 96.7% of observed agreement and a quadratic kappa of 0.84 (p<0.001). Strong correlation was observed for BOT-8 with SDOT (r=0.67, p<0.001) and UPSITTM (r=0.86, p<0.001). Disposable cotton swabs showed an excellent agreement with a kappa of 0.79 compared to the original test. The cut-off point for anosmia was ≤ 3 (AUC=0.83, Se= 0.673, Sp=0.993). CONCLUSION BOT-8 offers an efficient and fast method to be used in clinical routine to assess the smell threshold, detection, memory, and identification. Disposable cotton swabs with odorants are a useful and safe method during the COVID-19 pandemic.
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Affiliation(s)
- M J Rojas-Lechuga
- Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,CIBER of Respiratory Diseases (CIBERES), Spain
| | - J C Ceballos
- Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | - M Valls-Mateus
- Department of Otorhinolaryngology, Hospital Universitari Son Espases, Mallorca, Spain
| | - P Mackers
- Department of Otorhinolaryngology, Hospital del Mar, Barcelona, Spain
| | - A Izquierdo-Domínguez
- Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,Department of Allergology, Consorci Sanitari de Terrassa, Barcelona, Spain.,Unidad Alergo Rino, Centro Médico Teknon, Barcelona, Spain
| | - M López-Chacón
- Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,CIBER of Respiratory Diseases (CIBERES), Spain
| | - C Langdon
- Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,CIBER of Respiratory Diseases (CIBERES), Spain
| | - F Mariño-Sánchez
- Rhinology and Skull Base Surgery Unit. Otorhinolaryngology Department, Hospital Ramón y Cajal, Madrid, Spain
| | - J Valero
- Departament de Fisicoquímica. Facultat de Farmàcia. Universitat de Barcelona, Spain
| | - J Mullol
- Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,CIBER of Respiratory Diseases (CIBERES), Spain
| | - I Alobid
- Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,CIBER of Respiratory Diseases (CIBERES), Spain.,Unidad Alergo Rino, Centro Médico Teknon, Barcelona, Spain
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Abstract
BACKGROUND Septoplasty is one of the most frequently performed surgeries. However, there remains a question as to the effect of such intervention on the sense of smell. This study aims to examine the available evidence regarding the effect of septoplasty on the sense of smell. METHODS A database search was performed using PubMed, ScienceDirect, Google Scholar and The Cochrane Library databases from January 1990 to February 2020. Search terms included smell, olfaction, odor, septum, septoplasty, and septorhinoplasty. A meta-analysis was performed with 12 studies that provided sufficient data on change in olfaction. RESULTS 14 studies met the inclusion criteria, and 2 additional studies were included manually; comprising a total of 996 patients and 25 controls. Significant improvement in olfactory test scores was observed in all tests. Pre- and postoperative differences in means were 0.63 for BSIT, 0.80 for CCCRC test, 1.16 for odor threshold, 1.43 for odor discrimination, and 1.18 for odor identification. CONCLUSIONS Septoplasty seems to improve olfactory function. However, the outcome of this intervention is discrete and not equal for all patients, so further randomized trials are needed to confirm current findings.
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Affiliation(s)
- A Grabosky
- Medical Graduate, University of Barcelona, Barcelona, Spain
| | - P Mackers
- Department of Otorhinolaryngology, Hospital del Mar, Barcelona, Spain
| | - C Langdon
- Rhinology and Skull base Unit, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona. IDIBAPS Barcelona, Spain; Centre for Biomedical Research on Respiratory Diseases (CIBERES). Barcelona, Spain
| | - I Alobid
- Rhinology and Skull base Unit, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona. IDIBAPS Barcelona, Spain; Centre for Biomedical Research on Respiratory Diseases (CIBERES). Barcelona, Spain
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