Nasal obstruction secondary to nasal septal deviation and inferior turbinate hypertrophy is one of the commonest complaints presenting to the rhinologist. Some of these patients also complain of hyposmia. This study aims to investigate whether septoplasty and inferior turbinate reduction improve olfaction, nasal airflow and quality of life.
Prospective patients presenting to the rhinology clinic with nasal obstruction were questioned about olfactory problems. Eight hyposmic patients (6 males, mean age 41.5 years, range 21-65) with deviated nasal septa and bilateral inferior turbinate hypertrophy were evaluated pre-operatively. Septal deviation and inferior turbinate size were classified as described by Mladina and Camacho et al respectively. Patients filled in a Nasal Obstruction and Septoplasty Effectiveness (NOSE) Scale, peak nasal inspiratory flow rate (PNIF) was measured and a British version of the University of Pennsylvania Smell Identification Test (UPSIT) administered. All patients underwent endoscopic septoplasty and inferior reduction surgery. No packing was used. Patients were re-evaluated post-operatively at 2-12 weeks (mean 5 weeks).
Mean pre-op NOSE score was 15.7/20, which improved significantly post-op to 6.1/20 (p=0.008). An improvement in PNIF was noted from a mean of 83.8L/min to 93.8L/min; this was not statistically significant (p=0.344). UPSIT improved from a mean of 24.5/40 to 27.6/40 (p=0.047).
Septoplasty and inferior turbinate reduction surgery can significantly improve quality of life and olfaction, and also nasal airflow. No significant correlation was noted between pre and post-op NOSE, PNIF and UPSIT. However, this pilot study suggests that olfaction may serve as an independent outcome measure for nasal obstruction surgery.