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European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 1, pp 87–92 | Cite as

Intranasal trigeminal sensitivity: measurements before and after nasal surgery

  • M. Scheibe
  • S. Schulze
  • C. A. Mueller
  • B. Schuster
  • Thomas HummelEmail author
Rhinology

Abstract

Nasal surgeries constitute an extensive manipulation of the nasal mucosa and therefore of structures related to trigeminal and olfactory sensitivity. While olfactory changes due to nasal surgery are relatively well investigated, there are only very few studies regarding trigeminal sensitivity. Aim of the present study was to investigate sensory changes after nasal surgery with special regard to the trigeminal sensitivity. In 38 patients prior to and around 12 weeks after nasal surgery the following psychophysical measures were performed: odor identification, odor discrimination, phenyl ethyl alcohol odor threshold, sensitivity to trigeminal stimuli, trigeminal detection thresholds and trigeminal pain thresholds. These results were compared to those of a control group (43 healthy volunteers). Psychophysical olfactory and trigeminal testing showed no major changes in patients after surgery compared to the control group. Independent from the time of measurement higher trigeminal detection thresholds were found in patients compared to healthy subjects, meaning that trigeminal thresholds were already increased before surgery. The present study revealed a decreased trigeminal sensitivity in patients already before surgery. It may be hypothesized that patients also exhibit a decreased sensitivity for nasal airflow, which may also contribute to the patients’ impression of impaired nasal breathing.

Keywords

Surgery Trigeminal sensitivity Smell Nose Airflow 

Notes

Acknowledgments

We would like to thank Dr. Ioannis Charalampakis for his helpful comments on the manuscript.

Conflict of Interest

There are no financial disclosures from any of the authors.

References

  1. 1.
    Cain WS, Murphy C (1980) Interaction between chemoreceptive modalities of odour and irritation. Nature 284:255–257PubMedCrossRefGoogle Scholar
  2. 2.
    Chung BJ, Batra PS, Citardi MJ, Lanza DC (2007) Endoscopic septoplasty: revisitation of the technique, indications, and outcomes. Am J Rhinol 21:307–311PubMedCrossRefGoogle Scholar
  3. 3.
    Courtiss EH, Goldwyn RM (1983) The effects of nasal surgery on airflow. Plast Reconstr Surg 72:9–21PubMedCrossRefGoogle Scholar
  4. 4.
    Damm M, Eckel HE, Jungehulsing M, Hummel T (2003) Olfactory changes at threshold and suprathreshold levels following septoplasty with partial inferior turbinectomy. Ann Otol Rhinol Laryngol 112:91–97PubMedGoogle Scholar
  5. 5.
    Delank KW, Stoll W (1994) Sense of smell before and after endonasal surgery in chronic sinusitis with polyps. HNO 42:619–623PubMedGoogle Scholar
  6. 6.
    Dinis PBHH (2002) Septoplasty: long-term evaluation of results. Am J Otolaryngol 23:85–90PubMedCrossRefGoogle Scholar
  7. 7.
    Doty RL, Brugger WPE, Jurs PC, Orndorff MA, Snyder PJ, Lowry LD (1978) Intranasal trigeminal stimulation from odorous volatiles: psychometric responses from anosmic and normal humans. Physiol Behav 20:175–185PubMedCrossRefGoogle Scholar
  8. 8.
    Dürr J, Lindemann J, Keck T (2002) Untersuchungen zur Riechfunktion vor und nach funktionell-ästhetischer Nasenoperation. HNO 50:626–629PubMedCrossRefGoogle Scholar
  9. 9.
    Fettman N, Sanford T, Sindwani R (2009) Surgical management of the deviated septum: techniques in septoplasty. Otolaryngol Clin North Am 42:241–252PubMedCrossRefGoogle Scholar
  10. 10.
    Frasnelli J, Heilmann S, Hummel T (2004) Responsiveness of the human nasal mucosa to trigeminal stimuli depends on the site of stimulation. Neurosci Lett 362:65–69PubMedCrossRefGoogle Scholar
  11. 11.
    Garcia GJ, Rhee JS, Senior BA, Kimbell JS (2010) Septal deviation and nasal resistance: an investigation using virtual surgery and computational fluid dynamics. Am J Rhinol Allerg 24:e46–e53CrossRefGoogle Scholar
  12. 12.
    Geisler MW, Murphy C (2000) Event-related brain potentials to attended and ignored olfactory and trigeminal stimuli. Int J Psychophysiol 37:309–315PubMedCrossRefGoogle Scholar
  13. 13.
    Grützenmacher S, Robinson DM, Grafe K, Lang C, Mlynski G (2006) First findings concerning airflow in noses with septal deviation and compensatory turbinate hypertrophy—a model study. ORL 68:199–205PubMedCrossRefGoogle Scholar
  14. 14.
    Gudziol H, Schubert M, Hummel T (2001) Decreased trigeminal sensitivity in anosmia. ORL J Otorhinolaryngol Relat Spec 63:72–75PubMedCrossRefGoogle Scholar
  15. 15.
    Handwerker H, Kobal G (1993) Psychophysiology of experimentally induced pain. Physiol Rev 73:639–671PubMedGoogle Scholar
  16. 16.
    Hummel T, Barz S, Lötsch J, Roscher S, Kettenmann B, Kobal G (1996) Loss of olfactory function leads to a decrease of trigeminal sensitivity. Chem Senses 21:75–79PubMedCrossRefGoogle Scholar
  17. 17.
    Hummel T, Kobal G (1992) Differences in human evoked potentials related to olfactory or trigeminal chemosensory activation. Electroenceph Clin Neurophysiol 84:84–89PubMedCrossRefGoogle Scholar
  18. 18.
    Hummel T, Livermore A (2002) Intranasal chemosensory function of the trigeminal nerve and aspects of its relation to olfaction. Int Arch Occ Env Health 75:305–313CrossRefGoogle Scholar
  19. 19.
    Iannilli E, Gerber J, Frasnelli J, Hummel T (2007) Intranasal trigeminal function in subjects with and without an intact sense of smell. Brain Res 1139:235–244PubMedCrossRefGoogle Scholar
  20. 20.
    Illum P (1997) Septoplasty and compensatory inferior turbinate hypertrophy: long-term results after randomized turbinoplasty. Eur Arch Otorhinolaryngol 254(Suppl 1):S89–S92PubMedCrossRefGoogle Scholar
  21. 21.
    Jones AS, Crosher R, Wight RG, Lancer JM, Beckingham E (1987) The effect of local anaesthesia of the nasal vestibule on nasal sensation of airflow and nasal resistance. Clin Otolaryngol Allied Sci 12:461–464PubMedCrossRefGoogle Scholar
  22. 22.
    Kimmelman CP (1994) The risk to olfaction from nasal surgery. Laryngoscope 104:981–988PubMedCrossRefGoogle Scholar
  23. 23.
    Kobal G (1981) Elektrophysiologische Untersuchungen des menschlichen Geruchssinns. Thieme, StuttgartGoogle Scholar
  24. 24.
    Kobal G, Klimek L, Wolfensberger M, Gudziol H, Temmel A, Owen CM, Seeber H, Pauli E, Hummel T (2000) Multicenter investigation of 1,036 subjects using a standardized method for the assessment of olfactory function combining tests of odor identification, odor discrimination, and olfactory thresholds. Eur Arch Otorhinolaryngol 257:205–211PubMedCrossRefGoogle Scholar
  25. 25.
    Konstantinidis I, Triaridis S, Triaridis A, Petropoulos I, Karagiannidis K, Kontzoglou G (2005) How do children with adenoid hypertrophy smell and taste? clinical assessment of olfactory function pre- and post-adenoidectomy. Int J Pediatr Otorhinolaryngol 69:1343–1349PubMedCrossRefGoogle Scholar
  26. 26.
    Laska M, Distel H, Hudson R (1997) Trigeminal perception of odorant quality in congenitally anosmic subjects. Chem Senses 22:447–456PubMedCrossRefGoogle Scholar
  27. 27.
    Livermore A, Hummel T, Kobal G (1992) Chemosensory evoked potentials in the investigation of interactions between the olfactory and the somatosensory (trigeminal) systems. Electroenceph Clin Neurophysiol 83:201–210PubMedCrossRefGoogle Scholar
  28. 28.
    Minovi A, Hummel T, Ural A, Draf W, Bockmühl U (2007) Predictors of the outcome of nasal surgery in terms of olfactory function. Eur Arch Otorhinolaryngol 265:57–62PubMedCrossRefGoogle Scholar
  29. 29.
    Müller CA, Reiter M, Renner B (2007) Diagnostik von Riech- und Schmeckstörungen in der klinischen Routine. Laryngorhinootologie 86:630–633PubMedCrossRefGoogle Scholar
  30. 30.
    Nishino T, Tagaito Y, Sakurai Y (1997) Nasal inhalation of l-menthol reduces respiratory discomfort associated with loaded breathing. Am J Respir Crit Care Med 156:309–313PubMedCrossRefGoogle Scholar
  31. 31.
    Pfaar O, Huttenbrink KB, Hummel T (2004) Assessment of olfactory function after septoplasty: a longitudinal study. Rhinology 42:195–199PubMedGoogle Scholar
  32. 32.
    Reeh PW, Kress M (2001) Molecular physiology of proton transduction in nociceptors. Curr Opin Pharmacol 1:45–51PubMedCrossRefGoogle Scholar
  33. 33.
    Sant’Ambrogio G, Tsubone H, Sant’Ambrogio FB (1995) Sensory information from the upper airway: role in the control of breathing. Resp Physiol 102:1–16CrossRefGoogle Scholar
  34. 34.
    Scheibe M, Zahnert T, Hummel T (2006) Topographical differences in the trigeminal sensitivity of the human nasal mucosa. NeuroReport 17:1417–1420PubMedCrossRefGoogle Scholar
  35. 35.
    Silver WL (1991) Physiological factors in nasal trigeminal chemoreception. In: Green, B. G. et al., (eds) Chemical Senses, Irritation, Vol 2. Marcel Dekker, New York, pp 21–37 Google Scholar
  36. 36.
    Thürauf N, Gunther M, Pauli E, Kobal G (2002) Sensitivity of the negative mucosal potential to the trigeminal target stimulus CO(2). Brain Res 942:79–86PubMedCrossRefGoogle Scholar
  37. 37.
    Tsubone H (1989) Nasal ‘flow’ receptors of the rat. Resp Physiol 75:51–64CrossRefGoogle Scholar
  38. 38.
    Tsubone H (1990) Nasal ‘pressure’ receptors. Nippon juigaku zasshi 52:225–232PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • M. Scheibe
    • 1
  • S. Schulze
    • 1
  • C. A. Mueller
    • 2
  • B. Schuster
    • 1
  • Thomas Hummel
    • 1
    Email author
  1. 1.Department of Otorhinolaryngology, Smell and Taste ClinicUniversity of Dresden Medical SchoolDresdenGermany
  2. 2.Department of OtorhinolaryngologyMedical University of ViennaViennaAustria

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