Esteves Sofia, Sousa-Machado André, Silva Ana, Meireles Luís, Almeida Anabela
Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal.
Otolaryngology Head and Neck Surgery, Centro Hospitalar Universitário de Santo António (CHUP), Instituto Ciências Biomédicas Abel Salazar - Universidade do Porto, Largo Prof. Abel Salazar, Porto, 4099-001 Portugal.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):3895-3904. doi: 10.1007/s12070-024-04739-z. Epub 2024 May 11.
This study aimed to comprehend the influence of surgery on the lateral nasal wall, primarily focusing on the inferior turbinates, and its impact on olfactory function. A systematic review was carried out utilizing electronic databases like PubMed, Cochrane (including various registers and databases), and Web of Science. No restrictions were imposed on publication year or language. The PRISMA criteria guided study selection, and predefined inclusion and exclusion criteria were employed. Risk of bias assessment for randomized controlled trials (RCTs) utilized the "Revised Cochrane risk-of-bias tool for randomized trials (RoB 2)," while Hawker et al. scale evaluated the quality of non-RCT studies. The review encompassed nine studies after rigorous selection and bias assessment. All studies unanimously demonstrated improved olfactory function following surgery on the inferior turbinate. Different surgical techniques and olfactory assessment methods were employed across studies. Evaluation encompassed pre- and post-surgery olfactory measurements. Most studies employed the Visual Analogue Scale (VAS) and commercial smell test kits (like Sniffin' Stick Test). The Nasal Obstruction Symptom Evaluation (NOSE) scale was used in two studies, and the butanol threshold test in one. Olfactory improvement was measured through enhanced patient numbers or nasal cavities, often expressed via VAS scores. One study utilized both patient count and VAS scores. A few studies also employed NOSE scale and olfactory threshold measurements. All studies consistently concluded that olfactory function post-surgery was superior to preoperative measures. The collective evidence strongly suggests that surgery on inferior turbinates has a positive impact on olfactory function, as indicated by the studies reviewed. Nonetheless, for a comprehensive understanding of surgical efficacy, future research should incorporate randomized controlled trials featuring control groups. This would facilitate the establishment of optimal surgical techniques for specific indications and the formulation of practical guidelines.
本研究旨在了解手术对鼻侧壁的影响，主要关注下鼻甲，及其对嗅觉功能的影响。利用电子数据库进行了系统评价，如PubMed、Cochrane（包括各种注册库和数据库）以及Web of Science。对发表年份或语言没有限制。采用PRISMA标准指导研究选择，并使用预先定义的纳入和排除标准。随机对照试验（RCT）的偏倚风险评估使用“修订的Cochrane随机试验偏倚风险工具（RoB 2）”，而Hawker等人的量表评估非RCT研究的质量。经过严格筛选和偏倚评估后，该综述纳入了9项研究。所有研究一致表明，下鼻甲手术后嗅觉功能有所改善。各项研究采用了不同的手术技术和嗅觉评估方法。评估包括术前和术后的嗅觉测量。大多数研究采用视觉模拟量表（VAS）和商业嗅觉测试试剂盒（如嗅棒测试）。两项研究使用了鼻阻塞症状评估（NOSE）量表，一项研究使用了丁醇阈值测试。嗅觉改善通过患者数量或鼻腔数量的增加来衡量，通常通过VAS评分来表示。一项研究同时使用了患者数量和VAS评分。一些研究还采用了NOSE量表和嗅觉阈值测量。所有研究一致得出结论，术后嗅觉功能优于术前测量结果。综合证据强烈表明，如所综述的研究所示，下鼻甲手术对嗅觉功能有积极影响。然而，为了全面了解手术疗效，未来的研究应纳入有对照组的随机对照试验。这将有助于确定针对特定适应症的最佳手术技术，并制定实用指南。
