The risk to olfaction from nasal surgery

Implicit in all types of nasal surgery is the potential for worsening of olfactory function. Not only can injury occur to the delicate olfactory neuroepithelium itself, but also more indirect disturbances are engendered by pharmacologic agents, distortions of intranasal anatomy, persistent mucosal edema or crusts, and other processes. This study examined 93 patients undergoing various types of nasal surgery, including ethmoidectomy, polypectomy, Caldwell-Luc procedure, open reduction of nasal fracture, closed reduction of nasal fracture, rhinoplasty, and septoplasty. Factors considered as contributing to loss of olfactory acuity were age, gender, use of general anesthesia, and type of operation. The University of Pennsylvania Smell Identification Test (UPSIT), a 40-item, microencapsulated scratch-and-sniff procedure, was used to ascertain olfactory ability. Sixty-one patients (66%) had either improved or unchanged UPSIT scores after surgery; the remaining 32 patients (34%) had a decline in score. One patient (1%) became anosmic. Statistical treatment of outcome data using analysis of covariance with repeated measures showed no effect of age, gender, type of operation, or anesthetic.