Implications of Intranasal Trigeminal Nerve Function on the Surgical Management of Nasal Obstruction

Background: Surgical interventions for nasal obstruction represent a significant proportion of everyday rhinology practice. Failure to improve patients' symptoms may be due to incomplete assessment of co-morbidities, low sensitivity for nasal airflow, and inadequate therapeutic approaches. This narrative review summarizes the evidence on studies assessing the results of nasal obstruction surgery in relation to trigeminal function measurements. Focus was given to specific procedures such as septoplasty, endoscopic sinus surgery, and surgery of inferior turbinates. Summary: Current literature provides evidence that a significant proportion of patients have decreased intranasal trigeminal function before surgery. Most nasal surgeries conserve trigeminal nerve function, except when more aggressive techniques like inferior turbinate resection or excessive cautery are performed. Key Messages: Trigeminal function should be evaluated in patients presenting with nasal obstruction, especially in the absence of major anatomical blockage. Nasal trigeminal sensitivity may be a contributing factor to perceived obstruction that surgery alone cannot resolve.