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Olfactory Function and Surgery of the Lateral Nasal Wall – Systematic Review

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Abstract

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.

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Data Availability

The data sets used and/or analyzed during the current study are available from the corresponding author upon request.

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Author notes

  1. André Sousa-Machado and Sofia Rolão Esteves contributed equally to this work, and should be considered as co-first authors.

Authors and Affiliations

  1. Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal

    Sofia Esteves

  2. 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

    André Sousa-Machado, Ana Silva & Luís Meireles

  3. NECE - Research Center for Business Sciences, Universidade da Beira Interior, Covilhã, Portugal

    Anabela Almeida

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  1. Sofia Esteves
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Correspondence to André Sousa-Machado.

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Ethical Approval

Ethical approval for the manuscript was appropriately waived by the relevant institutional review board or ethics committee. The decision to waive ethical approval is often based on the nature of the research and the absence of direct involvement with human subjects. In this particular case, as a systematic review, the study does not involve direct interactions or interventions with individuals. Consequently, the ethics committee deemed that formal ethical approval was not necessary due to the observational and analytical nature of the study. The manuscript diligently adheres to ethical standards as outlined in the Helsinki Declaration. The Helsinki Declaration provides a comprehensive framework to ensure the ethical treatment of human subjects in medical research. In this study, all aspects involving human subjects’ rights, safety, and well-being have been carefully considered and incorporated to maintain the highest level of ethical integrity.

Informed Consent

In the context of the manuscript, the requirement for informed consent has been deemed unnecessary due to the study’s methodology. As a systematic review, the research involves the synthesis and analysis of previously published data rather than direct interactions with participants. Given that this study does not involve any personal data collection or patient involvement, the concept of obtaining informed consent is not applicable.

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Esteves, S., Sousa-Machado, A., Silva, A. et al. Olfactory Function and Surgery of the Lateral Nasal Wall – Systematic Review. Indian J Otolaryngol Head Neck Surg (2024). https://doi.org/10.1007/s12070-024-04739-z

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