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Influence of a medialized middle turbinate on olfactory function: a prospective randomized double-blind study
Sang-Wook Kim1,2, Rock Bum Kim3, Hyunmo Kang1
1Department of Otorhinolaryngology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.
International Forum of Allergy & Rhinology
|January 5, 2019
Summary
Medializing the middle turbinate (MT) does not affect olfactory function. Olfactory cleft (OC) status, however, is closely linked to a patient's sense of smell, impacting outcomes after sinus surgery.
Area of Science:
- Otolaryngology
- Rhinology
- Olfactory Research
Background:
- Medialization of the middle turbinate (MT) is a surgical technique used to prevent recurrent rhinosinusitis.
- Concerns exist that MT medialization might negatively impact olfactory function by obstructing odorant pathways to the olfactory mucosa.
- This study investigated the relationship between MT medialization, olfactory cleft (OC) status, and olfactory function.
Purpose of the Study:
- To test the hypothesis that olfactory function is primarily influenced by the condition of the olfactory mucosa, not by MT medialization.
- To evaluate the effect of MT medialization on olfactory function in patients undergoing endoscopic sinus surgery.
- To determine the correlation between olfactory cleft status and olfactory function.
Main Methods:
- A prospective, randomized, double-blind trial involving 80 patients undergoing bilateral endoscopic sinus surgery.
- Unilateral MT medialization was performed on randomly selected sides.
- Olfactory cleft (OC) status was documented intraoperatively and categorized. Olfactory function was assessed using the butanol threshold test (BTT) preoperatively and 6 months postoperatively.
Main Results:
- Of 80 patients, 46 completed the trial. MT medialization did not significantly alter BTT scores compared to intact sides.
- Patients with a patent OC group demonstrated higher BTT scores (better olfactory function) than those in the congested OC group, irrespective of MT status.
- No significant difference in OC status was observed between the left and right nasal sides.
Conclusions:
- MT medialization is a safe procedure that does not impair olfactory function.
- The status of the olfactory cleft (patent vs. congested) is a significant determinant of olfactory function in patients with chronic rhinosinusitis.
- These findings suggest that optimizing OC status is crucial for preserving or improving olfactory function post-surgery.
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