Fyrmpas G, Tsalighopoulos M, Constantinidis J
1 Academic Department of Otolaryngology Head & Neck Surgery, AHEPA Hospital, Aristotle University of Thessaloniki, Greece.
Hippokratia. 2012 Apr;16(2):166-9.
Patients with a smell disorder and less often, healthy people, exhibit an olfactory difference between the two sides of the nose. Higher olfactory thresholds are correlated with the obstructed side of a nasal septal deviation (NSD). With this prospective study we sought to investigate if a NSD compromises the olfactory identification.
Thirty patients with nasal obstruction due to a NSD were recruited. The patients were listed for primary septoplasty with or without radiofrequency reduction of the inferior turbinates. Pre- and postoperatively, patients were assessed by visual analogue scales for symptoms and by the bilateral nasal spirometry (nasal partitioning ratio-NPR) for the side/degree of obstruction. Olfactory identification was tested separately for each nasal cavity by means of the 12 item Sniffin Sticks test (12-SS test) and a 3-point difference between the nasal sides was considered significant.
The mean age of patients (25 males/5 females) was 33 years (range 17-52). No complications or anosmia were reported postoperatively. Subjective hyposmia, nasal obstruction and the NPR were reduced (p<0.001). Significant lateralized differences were present in 20% and 13% of patients before and after septoplasty respectively; the change was not significant (p=0.754). Patients with a significant lateralized olfactory difference had a greater NPR pre- (p=0.031) but not postoperatively (p=0.783). The sides of obstruction and worst olfactory performance did not differ in these patients before surgery.
Olfactory identification may be compromised on the convex side of a large NSD. Post-operatively, patients exhibit a lateralised smell identification difference as often as healthy people. The effect of a clinically significant NSD on the different aspects of olfactory performance warrants further study.
嗅觉障碍患者，以及较少情况下的健康人，两侧鼻腔存在嗅觉差异。较高的嗅觉阈值与鼻中隔偏曲（NSD）的阻塞侧相关。通过这项前瞻性研究，我们旨在调查NSD是否会影响嗅觉识别。
招募30例因NSD导致鼻塞的患者。这些患者被安排进行初次鼻中隔成形术，可选择或不选择下鼻甲射频消融术。术前和术后，通过视觉模拟量表评估患者症状，并通过双侧鼻肺量计（鼻分隔比-NPR）评估阻塞的侧别/程度。通过12项嗅棒测试（12-SS测试）分别对每个鼻腔进行嗅觉识别测试，鼻腔两侧相差3分被认为具有显著性差异。
患者平均年龄为33岁（25例男性/5例女性，年龄范围17 - 52岁）。术后未报告并发症或嗅觉丧失。主观嗅觉减退、鼻塞和NPR均降低（p<0.001）。鼻中隔成形术前和术后分别有20%和13%的患者存在显著的侧别差异；差异无统计学意义（p = 0.754）。术前具有显著侧别嗅觉差异的患者NPR更高（p = 0.031），但术后无此差异（p = 0.783）。这些患者术前阻塞侧与嗅觉最差侧无差异。
大型NSD凸侧的嗅觉识别可能受到影响。术后，患者出现侧别嗅觉识别差异的频率与健康人相同。具有临床意义的NSD对嗅觉表现不同方面的影响值得进一步研究。
