Profiling nasal trigeminal sensitivity to predict outcomes after nasal obstruction surgery

Area of Science:

• Otorhinolaryngology
• Neurosurgery
• Sensory Science

Background:

• Predicting surgical outcomes for nasal airway obstruction is challenging due to poor correlation between objective airflow metrics and patient-reported outcomes.
• Trigeminal afferents are crucial for sensing nasal airflow, suggesting a role for trigeminal function in subjective perception.
• This study investigated if nasal chemosensory function, specifically trigeminal sensitivity, predicts outcomes in patients undergoing nasal obstruction surgery.

Purpose of the Study:

• To evaluate the association between individual differences in nasal trigeminal sensitivity and subjective airflow perception.
• To determine if trigeminal sensitivity predicts symptom improvement and patient satisfaction after nasal airway obstruction surgery.

Main Methods:

• Prospective cohort study of 43 participants (32 patients, 11 controls).
• Assessed trigeminal sensitivity via menthol lateralisation detection thresholds, TRPV1/TRPM8 gene expression, and the Barcelona Smell Test-24 trigeminal subtest.
• Measured nasal obstruction perception pre- and postoperatively using the NOSE-e questionnaire and visual analogue scale.

Main Results:

• No significant difference in trigeminal sensitivity between patients and controls.
• Baseline Barcelona Smell Test-24 trigeminal scores correlated with greater improvement in NOSE-e scores and patient satisfaction.
• Patients with significant NOSE-e improvement had lower baseline trigeminal scores.

Conclusions:

• Trigeminal sensitivity, assessed by the Barcelona Smell Test-24, may predict symptom improvement and satisfaction after nasal airway obstruction surgery.
• Sensory processing plays a vital role in patient-perceived surgical outcomes for nasal obstruction.