Sousa Francisco Alves de, Santos Mariline, Correia João Tavares, Pinto Ana Nóbrega, Meireles Luís, Ferreira Miguel
Serviço de Otorrinolaringologia e Cirurgia Cérvico-facial (Otorhinolaryngology and Head and Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal.
Facial Plast Surg. 2023 Feb;39(1):69-76. doi: 10.1055/a-1979-8636. Epub 2022 Nov 16.
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 ( = 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.
鼻中隔成形术（SRP）是全球最常开展的手术之一。关于鼻部手术对嗅觉功能（OF）的影响存在公认的争议。本研究的目的是评估鼻中隔成形术对术后晚期嗅觉功能的影响。采用全面综述和荟萃分析来评估鼻中隔成形术后的嗅觉功能。所有纳入的研究均使用客观工具对手术前后的嗅觉功能进行量化。进行了文献检索，并对所选文献进行评估、计算，最终纳入荟萃分析。使用美国国立卫生研究院（NIH）关于评估无对照组的前后对照研究质量的指南来评估偏倚风险。分析中仅考虑每项研究提供的最新随访嗅觉功能测量值。计算每项研究效应量的95%置信区间以阐明效应大小。分析纳入了11项研究。5项研究报告术后晚期嗅觉功能改善（45.5%），5项报告嗅觉功能无变化（45.5%），只有1项研究报告鼻中隔成形术后嗅觉功能受损（9%）。一些研究描述了术后不久嗅觉功能短暂下降，随后术后改善。汇总的荟萃分析表明，在晚期随访中，鼻中隔成形术后嗅觉功能无显著改变（ = 0.10）。从长期来看，鼻中隔成形术似乎是一种关于嗅觉功能的安全手术。根据研究，嗅觉功能在术后可能会暂时恶化，随后改善，有时会恢复到高于基线的值。在鼻中隔成形术的术前咨询中可以讨论干预后嗅觉功能的预期演变情况。
