The impact of tracheostomy on the nose

To establish the effect of tracheostomy on nasal function and quality of life. Teaching Hospital, Scotland, UK. Cross-sectional case-control study. Two groups of patients were selected; a group of ten patients who underwent surgical tracheostomy and a control group of ten patients with confirmed or suspected head and neck malignancy that did not require tracheostomy. Two questionnaires, the SNOT-22 quality of life instrument, and the Rhinogram nasal symptoms score were used to evaluate each group. For the Rhinogram questionnaire the median total score was 13.5 for the tracheostomy group and 2 for the control group (P = 0.02) whilst for the SNOT-22, the mean total scores were 39 and 29, respectively (P = 0.205). The tracheostomy group scored worse for all Rhinogram questions, and for the anosmia score this was independently statistically significant (5 vs. 0 units, P = 0.001). The tracheostomy group most commonly identified "loss of smell & taste" as their most important symptom, compared with only 2 subjects in the control group. Tracheostomy can give rise to nasal symptoms. This needs to be addressed in the routine follow up of these patients.