Olfaction in Juvenile Nasopharyngeal Angiofibroma: The first study
Anupam Mishra1, Pankaj Pandey1, Subhash Chandra Mishra1
1Department of Otorhinolaryngology and Head and Neck Surgery, King George's Medical University, Lucknow, India.
Background:
To study the pattern of olfactory dysfunction/recovery in juvenile nasopharyngeal angiofibroma (JNA).
Methods:
Olfactory assessment was undertaken in 30 patients (category1) both pre- & post-operatively and in another 18 (category 2) only postoperative. All patients underwent transpalatal excision and variables of interest included age, radiological stage/parameters & tumor size.
Results:
Objective olfactory dysfunction was seen in 60% while involvement of olfactory strip was suggested in 50%. Despite some marginal trends only noted between size/age with change of olfaction, Pearson's correlation test did not reveal any significance amongst multiple variables. However a better recovery of olfaction following surgery was evident in Category-2 where Chi-Square test (p < 0.05) significantly revealed this to be a function of postoperative duration. This regenerative course in JNA suggests an optimum period of 4 years for full recovery after surgery.
Conclusion:
In this first study of olfaction in JNA many new trends have been appreciated. In general, deteriorations of olfaction were seen due to 'vascular-concussion' effect in early postoperative phase where post-surgical clearance of airway showed minimal effect in terms of improvement. The hypervascularity of olfactory epithelium with possible hormonal effects may be responsible for the unique pattern of olfactory function and recovery in JNA.
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