Chen Yen-An, Chen Chih-Hao, Wang Wei-Hsin, Lan Ming-Ying
Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.
J Otolaryngol Head Neck Surg. 2025 Jan-Dec;54:19160216251351566. doi: 10.1177/19160216251351566. Epub 2025 Jun 27.
ObjectivesThe middle turbinate (MT) was considered related to olfactory function. Whether the MT should be partially resected during relevant surgery is still debated. Our primary objective was to compare the olfactory outcome between partial MT resection (MTR) and MT preservation (MTP).MethodsA search was performed on the Cochrane Library, Embase, PubMed, Scopus, and Web of Science databases from their inception through February 10, 2024. Eligible studies included those that compared the olfactory outcome between partial MTR and MTP. Data were extracted manually, and a random-effects model was used to evaluate it. We calculated the standardized mean differences (SMD) in the scores for the olfactory function. Further subgroup analysis was also performed for variables of interest. The pooled results were examined using influence analysis.ResultsAfter systematically reviewing all relevant articles, 7 studies were qualified for inclusion. The pooled results showed no significant difference in olfaction between the partial MTR and MTP (SMD, 0.140; 95% CI, -0.159 to 0.438; = .359; <1%). Subgroup analysis preferred partial MTR in the objective test (SMD, 0.370; 95% CI, 0.17-0.56; < .001; = 0%). No significance was observed in studies with subjective test (SMD, -0.271; 95% CI, -0.604 to 0.63; = .112; <1%), undergoing functional endoscopic sinus surgery (0.10; 95% CI, -0.35 to 0.54; = .67; = 85%), undergoing skull base surgery with endoscopic endonasal approach (SMD, 0.25; 95% CI, -0.04 to 0.53; = .09; = 0%), and following up more than 6 months (SMD, 0.09; 95% CI, -0.21 to 0.39; = .57; = 75%).ConclusionOur findings showed that MTR does not deteriorate olfactory function compared with MTP. Considering the potential benefit, partial MTR might be prioritized in clinical settings.
目的
中鼻甲(MT)被认为与嗅觉功能有关。在相关手术中MT是否应部分切除仍存在争议。我们的主要目的是比较部分中鼻甲切除术(MTR)和中鼻甲保留术(MTP)后的嗅觉结果。
方法
对Cochrane图书馆、Embase、PubMed、Scopus和Web of Science数据库从创建至2024年2月10日进行检索。符合条件的研究包括那些比较部分MTR和MTP后嗅觉结果的研究。数据手动提取,并使用随机效应模型进行评估。我们计算了嗅觉功能评分的标准化平均差(SMD)。还对感兴趣的变量进行了进一步的亚组分析。使用影响分析检查汇总结果。
结果
在系统回顾所有相关文章后,7项研究符合纳入标准。汇总结果显示,部分MTR和MTP后的嗅觉无显著差异(SMD,0.140;95%CI,-0.159至0.438;P = 0.359;I²<1%)。亚组分析显示,在客观测试中更倾向于部分MTR(SMD,0.370;95%CI,0.17 - 0.56;P<0.001;I² = 0%)。在主观测试的研究(SMD,-0.271;95%CI,-0.604至0.63;P = 0.112;I²<1%)、接受功能性鼻内镜鼻窦手术的研究(0.10;95%CI,-0.35至0.54;P = 0.67;I² = 85%)、接受内镜鼻内入路颅底手术的研究(SMD,0.25;95%CI,-0.04至0.53;P = 0.09;I² = 0%)以及随访超过6个月的研究(SMD,-0.09;95%CI,-0.21至0.39;P = 0.57;I² = 75%)中均未观察到显著差异。
结论
我们的研究结果表明,与MTP相比,MTR不会使嗅觉功能恶化。考虑到潜在益处,在临床环境中部分MTR可能更具优先性。