From the Division of Plastic and Reconstructive Surgery and the David Geffen School of Medicine, University of California, Los Angeles; and New York University School of Medicine.
Plast Reconstr Surg. 2021 Mar 1;147(3):707-718. doi: 10.1097/PRS.0000000000007667.
Functional and aesthetic nasal operations are some of the most common plastic surgery procedures performed in the United States. The purpose of the study was to evaluate the effects of septoplasty, septorhinoplasty, and rhinoplasty procedures on postoperative olfactory function and their relationship to nasal airflow and quality of life.
A systematic review and meta-analysis was performed evaluating olfactory function following nasal surgery. Preoperative and postoperative values for olfaction, nasal airflow, and quality of life/nasal symptoms were analyzed. The effect size was calculated from each study and used for meta-analysis. As studies evaluated patients at different points in the postoperative period, the latest time point reported by each study was used in the meta-analysis. The 95 percent confidence interval of the effect size was calculated for each study. Study quality was assessed using the Jadad and Methodological Index for Nonrandomized Studies instruments. All included studies were Level of Evidence II.
There were 25 included studies. Following nasal surgery, patients experienced significant improvements in olfaction (p < 0.001), nasal airflow (p < 0.001), and quality of life/nasal symptoms (p < 0.001). Patients often experienced a transient decrease in olfaction immediately after surgery, followed by improvement postoperatively. Preoperative olfactory dysfunction rates were low and postoperative dysfunction was equally low. Olfaction improvement was directly correlated with improvement in nasal airflow and quality of life.
Functional and aesthetic nasal operations appear to significantly improve olfaction, which is directly correlated with nasal airflow. Some studies report a transient worsening of these measures in the immediate postoperative period, which subsequently improved at later time points.
功能性和美学鼻部手术是美国最常见的整形手术之一。本研究的目的是评估鼻中隔成形术、鼻中隔成形术和鼻成形术对术后嗅觉功能的影响，以及它们与鼻气流和生活质量的关系。
系统回顾和荟萃分析评估了鼻部手术后的嗅觉功能。分析了嗅觉、鼻气流和生活质量/鼻部症状的术前和术后值。从每项研究中计算出效应大小，并用于荟萃分析。由于研究评估了不同术后时期的患者，因此荟萃分析中使用了每项研究报告的最新时间点。计算了每个研究的效应大小的 95%置信区间。使用 Jadad 和非随机研究方法学指数评估研究质量。所有纳入的研究均为证据水平 II 类。
共纳入 25 项研究。鼻手术后，患者嗅觉（p < 0.001）、鼻气流（p < 0.001）和生活质量/鼻部症状（p < 0.001）显著改善。患者术后常立即出现短暂的嗅觉下降，随后术后改善。术前嗅觉障碍发生率较低，术后障碍发生率同样较低。嗅觉改善与鼻气流和生活质量的改善直接相关。
功能性和美学鼻部手术似乎可显著改善嗅觉，而嗅觉与鼻气流直接相关。一些研究报告在术后即刻这些指标会出现短暂恶化，随后在后期时间点改善。
