Download PDF
CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2020; 24(02): e237-e246
DOI: 10.1055/s-0040-1701269
Original Research
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

The Impact of Olfactory Dysfunction on the Psychological Status and Quality of Life of Patients with Nasal Obstruction and Septal Deviation

Konstantinos Valsamidis
1   1st Otolaryngology Department, Medical school, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
,
Athanasia Printza 
1   1st Otolaryngology Department, Medical school, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
,
Jannis Constantinidis
1   1st Otolaryngology Department, Medical school, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
,
Stefanos Triaridis
1   1st Otolaryngology Department, Medical school, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
› Author Affiliations
Further Information

Publication History

05 August 2019

03 December 2019

Publication Date:
27 February 2020 (online)

   Permissions and Reprints

Abstract

Introduction Olfactory dysfunction may be present in patients with nasal obstruction and septal deviation. The impact of olfactory dysfunction on the psychological profile and quality of life (QoL) of these patients remains unexplored.

Objective The present study aimed to investigate the emotional status and QoL of patients with olfactory dysfunction and septal deviation and to identify predictors associated with clinically significant improvement of psychological status and QoL, focusing mainly on the role of olfactory recovery after septoplasty.

Methods The olfactory function was quantitatively assessed using the ‘‘Sniffin’ sticks'' test (Burghart Messtechnik GmbH, Wedel, Germany) in 60 patients and 25 controls enrolled in this prospective study. The participants completed validated questionnaires specific for general health (Short Form-36), nasal-symptom related QoL (SinoNasal Outcome Test-22), olfaction-associated QoL (Questionnaire of Olfactory Deficits) and for assessing their psychological state (Short Anxiety Screening Test and Beck Depression Inventory) preoperatively and 6 months postoperatively. The patients used the Glasgow Benefit Inventory to evaluate their personal benefit after septoplasty with.

Results Septoplasty led to significantly improved olfactory function. Patients with olfactory impairment had significantly lower nasal-symptom related QoL, higher stress levels, and more depressive mood compared with normosmics and controls before and after septoplasty. Postoperatively, personal benefit from surgery was higher in normosmic patients. Improvement of nasal-symptom related QoL was significantly associated with higher likelihood of clinically significant improvement of patients' psychological profile and more personal benefit from surgery. Olfactory dysfunction was negatively correlated with the emotional status of the patients.

Conclusion Olfactory dysfunction appears to significantly affect the psychological status of patients with nasal obstruction, and olfactory recovery improves the patients' perception of personal benefit from septoplasty.

Keywords

olfactory dysfunction - septoplasty - anxiety - emotional status - quality of life - olfaction test
 

  • References

  • 1 Damm M, Eckel HE, Jungehülsing M, Hummel T. Olfactory changes at threshold and suprathreshold levels following septoplasty with partial inferior turbinectomy. Ann Otol Rhinol Laryngol 2003; 112 (01) 91-97
    CrossrefPubMedGoogle Scholar
  • 2 Croy I, Nordin S, Hummel T. Olfactory disorders and quality of life--an updated review. Chem Senses 2014; 39 (03) 185-194
    CrossrefPubMedGoogle Scholar
  • 3 Marschner H, Gudziol H, Guntinas-Lichius O. [Olfactory dysfunctions are substantially more frequent than they are complained]. Laryngorhinootologie 2010; 89 (11) 654-659
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Shu CH, Lee PO, Lan MY, Lee YL. Factors affecting the impact of olfactory loss on the quality of life and emotional coping ability. Rhinology 2011; 49 (03) 337-341
    PubMedGoogle Scholar
  • 5 Smeets MAM, Veldhuizen MG, Galle S. , et al. Sense of smell disorder and health-related quality of life. Rehabil Psychol 2009; 54 (04) 404-412
    CrossrefPubMedGoogle Scholar
  • 6 Brämerson A, Nordin S, Bende M. Clinical experience with patients with olfactory complaints, and their quality of life. Acta Otolaryngol 2007; 127 (02) 167-174
    CrossrefPubMedGoogle Scholar
  • 7 Moore M, Eccles R. Objective evidence for the efficacy of surgical management of the deviated septum as a treatment for chronic nasal obstruction: a systematic review. Clin Otolaryngol 2011; 36 (02) 106-113
    CrossrefPubMedGoogle Scholar
  • 8 de Ru JA. Septoplasty is a proven and effective procedure: an expert's view of a burning issue. B-ENT 2015; 11 (04) 257-262
    PubMedGoogle Scholar
  • 9 Valsamidis K, Titelis K, Rachovitsas D, Konstantinidis I, Markou K, Triaridis S. Long-Term Evaluation of Nasal Septoplasty Followed by Inferior Turbinate Cauterization for the Treatment of Nasal Obstruction using Objective and Subjective Methods. Int Arch Otorhinolaryngol 2018; 22 (03) 284-290
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Tsang CLN, Nguyen T, Sivesind T, Cervin A. Long-term patient-related outcome measures of septoplasty: a systematic review. Eur Arch Otorhinolaryngol 2018; 275 (05) 1039-1048
    CrossrefPubMedGoogle Scholar
  • 11 Aydoğdu I, Atar Y, Aydoğdu Z. , et al. Comparison of Olfactory Function and Quality of Life With Different Surgical Techniques for Nasal Septum Deviation. J Craniofac Surg 2019; 30 (02) 433-436
    CrossrefPubMedGoogle Scholar
  • 12 Haytoğlu S, Dengiz R, Muluk NB, Kuran G, Arikan OK. Effects of septoplasty on olfactory function evaluated by the Brief Smell Identification Test: A study of 116 patients. Ear Nose Throat J 2017; 96 (10-11): 433-438
    CrossrefPubMedGoogle Scholar
  • 13 Türk B, Akpinar M, Altundağ A, Kirik MÖ, Ünsal Ö, Coşkun BU. The Effect of External Approach Septoplasty on Olfactory Function. J Craniofac Surg 2017; 28 (07) 1675-1678
    CrossrefPubMedGoogle Scholar
  • 14 Kilicaslan A, Acar GO, Tekin M, Ozdamar OI. Assessment the long-term effects of septoplasty surgery on olfactory function. Acta Otolaryngol 2016; 136 (10) 1079-1084
    CrossrefPubMedGoogle Scholar
  • 15 Gupta N, Singh PP, Bagla RK. Will septal correction surgery for deviated nasal septum improve the sense of smell? A prospective study. Surg Res Pract 2015; 2015: 496542 . Doi: 10.1155/2015/496542
    PubMedGoogle Scholar
  • 16 Fyrmpas G, Tsalighopoulos M, Constantinidis J. Lateralized olfactory difference in patients with a nasal septal deviation before and after septoplasty. Hippokratia 2012; 16 (02) 166-169
    PubMedGoogle Scholar
  • 17 Pade J, Hummel T. Olfactory function following nasal surgery. Laryngoscope 2008; 118 (07) 1260-1264
    CrossrefPubMedGoogle Scholar
  • 18 Pfaar O, Hüttenbrink KB, Hummel T. Assessment of olfactory function after septoplasty: a longitudinal study. Rhinology 2004; 42 (04) 195-199
    PubMedGoogle Scholar
  • 19 Valsamidis K, Titelis K, Karkos P, Markou K, Constantinidis J, Triaridis S. Predictive factors of patients' general quality of life after nasal septoplasty. Eur Arch Otorhinolaryngol 2019; 276 (02) 429-438
    CrossrefPubMedGoogle Scholar
  • 20 Cantone E, Ricciardiello F, Oliva F, De Corso E, Iengo M. Septoplasty: is it possible to identify potential “predictors” of surgical success?. Acta Otorhinolaryngol Ital 2018; 38 (06) 528-535
    CrossrefPubMedGoogle Scholar
  • 21 Stewart MG, Smith TL, Weaver EM. , et al. Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Head Neck Surg 2004; 130 (03) 283-290
    CrossrefPubMedGoogle Scholar
  • 22 Karatzanis AD, Fragiadakis G, Moshandrea J, Zenk J, Iro H, Velegrakis GA. Septoplasty outcome in patients with and without allergic rhinitis. Rhinology 2009; 47 (04) 444-449
    PubMedGoogle Scholar
  • 23 Hytönen ML, Lilja M, Mäkitie AA, Sintonen H, Roine RP. Does septoplasty enhance the quality of life in patients?. Eur Arch Otorhinolaryngol 2012; 269 (12) 2497-2503
    CrossrefPubMedGoogle Scholar
  • 24 Hong SD, Lee NJ, Cho HJ. , et al. Predictive factors of subjective outcomes after septoplasty with and without turbinoplasty: can individual perceptual differences of the air passage be a main factor?. Int Forum Allergy Rhinol 2015; 5 (07) 616-621
    CrossrefPubMedGoogle Scholar
  • 25 Shiryaeva O, Tarangen M, Gay C, Døsen LK, Haye R. Preoperative signs and symptoms as prognostic markers in nasal septoplasty. Int J Otolaryngol 2017; 2017: 4718108 . Doi: 10.1155/2017/47181
    PubMedGoogle Scholar
  • 26 Kobal G, Hummel T, Sekinger B, Barz S, Roscher S, Wolf S. “Sniffin' sticks”: screening of olfactory performance. Rhinology 1996; 34 (04) 222-226
    PubMedGoogle Scholar
  • 27 Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G. ‘Sniffin’ sticks': olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses 1997; 22 (01) 39-52
    CrossrefPubMedGoogle Scholar
  • 28 Oleszkiewicz A, Schriever VA, Croy I, Hähner A, Hummel T. Updated Sniffin' Sticks normative data based on an extended sample of 9139 subjects. Eur Arch Otorhinolaryngol 2019; 276 (03) 719-728
    CrossrefPubMedGoogle Scholar
  • 29 Konstantinidis I, Printza A, Genetzaki S, Mamali K, Kekes G, Constantinidis J. Cultural adaptation of an olfactory identification test: the Greek version of Sniffin' Sticks. Rhinology 2008; 46 (04) 292-296
    PubMedGoogle Scholar
  • 30 Klimek L, Hummel T, Moll B, Kobal G, Mann WJ. Lateralized and bilateral olfactory function in patients with chronic sinusitis compared with healthy control subjects. Laryngoscope 1998; 108 (1 Pt 1): 111-114
    CrossrefPubMedGoogle Scholar
  • 31 Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg 2004; 130 (02) 157-163
    PubMedGoogle Scholar
  • 32 Lachanas VA, Tsiouvaka S, Tsea M, Hajiioannou JK, Skoulakis CE. Validation of the nasal obstruction symptom evaluation (NOSE) scale for Greek patients. Otolaryngol Head Neck Surg 2014; 151 (05) 819-823
    CrossrefPubMedGoogle Scholar
  • 33 Browne JP, Hopkins C, Slack R, Cano SJ. The Sino-Nasal Outcome Test (SNOT): can we make it more clinically meaningful?. Otolaryngol Head Neck Surg 2007; 136 (05) 736-741
    CrossrefPubMedGoogle Scholar
  • 34 Lachanas VA, Tsea M, Tsiouvaka S, Hajiioannou JK, Skoulakis CE, Bizakis JG. The sino-nasal outcome test (SNOT)-22: validation for Greek patients. Eur Arch Otorhinolaryngol 2014; 271 (10) 2723-2728
    CrossrefPubMedGoogle Scholar
  • 35 Frasnelli J, Hummel T. Olfactory dysfunction and daily life. Eur Arch Otorhinolaryngol 2005; 262 (03) 231-235
    CrossrefPubMedGoogle Scholar
  • 36 Simopoulos E, Katotomichelakis M, Gouveris H, Tripsianis G, Livaditis M, Danielides V. Olfaction-associated quality of life in chronic rhinosinusitis: adaptation and validation of an olfaction-specific questionnaire. Laryngoscope 2012; 122 (07) 1450-1454
    CrossrefPubMedGoogle Scholar
  • 37 Grammatikopoulos IA, Sinoff G, Alegakis A, Kounalakis D, Antonopoulou M, Lionis C. The Short Anxiety Screening Test in Greek: translation and validation. Ann Gen Psychiatry 2010; 9 (01) 1
    CrossrefPubMedGoogle Scholar
  • 38 Sinoff G, Ore L, Zlotogorsky D, Tamir A. Short Anxiety Screening Test--a brief instrument for detecting anxiety in the elderly. Int J Geriatr Psychiatry 1999; 14 (12) 1062-1071
    CrossrefPubMedGoogle Scholar
  • 39 Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory. San Antonio, TX: Psychological Corporation; 1996
    Google Scholar
  • 40 Giannakou M, Roussi P, Kosmides ME, Kiosseoglou G. Adaptation of the beck depression inventory-II to greek population. Hell J Psychol 2013; 10 (02) 120-146
    Google Scholar
  • 41 Ware Jr JE, Gandek B. Qverview of the SF-36 Health Survey and the international quality of life assessment (IQOLA) Project. J Clin Epidemiol 1998; 51 (11) 903-912
    CrossrefPubMedGoogle Scholar
  • 42 Anagnostopoulos F, Niakas D, Pappa E. Construct validation of the Greek SF-36 Health Survey. Qual Life Res 2005; 14 (08) 1959-1965
    CrossrefPubMedGoogle Scholar
  • 43 Robinson K, Gatehouse S, Browning GG. Measuring patient benefit from otorhinolaryngological surgery and therapy. Ann Otol Rhinol Laryngol 1996; 105 (06) 415-422
    CrossrefPubMedGoogle Scholar
  • 44 Konstantinidis I, Triaridis S, Printza A, Triaridis A, Noussios G, Karagiannidis K. Assessment of patient benefit from septo-rhinoplasty with the use of Glasgow Benefit Inventory (GBI) and Nasal Symptom Questionnaire (NSQ). Acta Otorhinolaryngol Belg 2003; 57 (02) 123-129
    PubMedGoogle Scholar
  • 45 Norman GR, Sloan JA, Wyrwich KW. Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 2003; 41 (05) 582-592
    PubMedGoogle Scholar
  • 46 Berkiten G, Kumral TL, Saltürk Z. , et al. Effect of Deviated Nasal Septum Type on Nasal Mucociliary Clearance, Olfactory Function, Quality of Life, and Efficiency of Nasal Surgery. J Craniofac Surg 2016; 27 (05) 1151-1155
    CrossrefPubMedGoogle Scholar
  • 47 Konstantinidis I, Triaridis S, Triaridis A, Karagiannidis K, Kontzoglou G. Long term results following nasal septal surgery. Focus on patients' satisfaction. Auris Nasus Larynx 2005; 32 (04) 369-374
    CrossrefPubMedGoogle Scholar
  • 48 Mondina M, Marro M, Maurice S, Stoll D, de Gabory L. Assessment of nasal septoplasty using NOSE and RhinoQoL questionnaires. Eur Arch Otorhinolaryngol 2012; 269 (10) 2189-2195
    CrossrefPubMedGoogle Scholar
  • 49 Uppal S, Mistry H, Nadig S, Back G, Coatesworth A. Evaluation of patient benefit from nasal septal surgery for nasal obstruction. Auris Nasus Larynx 2005; 32 (02) 129-137
    CrossrefPubMedGoogle Scholar
  • 50 Calder NJ, Swan IRC. Outcomes of septal surgery. J Laryngol Otol 2007; 121 (11) 1060-1063
    CrossrefPubMedGoogle Scholar
  • 51 Arunachalam PS, Kitcher E, Gray J, Wilson JA. Nasal septal surgery: evaluation of symptomatic and general health outcomes. Clin Otolaryngol Allied Sci 2001; 26 (05) 367-370
    CrossrefPubMedGoogle Scholar
  • 52 Bugten V, Nilsen AH, Thorstensen WM, Moxness MH, Amundsen MF, Nordgård S. Quality of life and symptoms before and after nasal septoplasty compared with healthy individuals. BMC Ear Nose Throat Disord 2016; 16: 13
    CrossrefPubMedGoogle Scholar
  • 53 Choi YS, Ryu YJ, Rhee J. , et al. Clinical Implications of Septal Deviation in Lateralized Olfaction. Clin Exp Otorhinolaryngol 2016; 9 (01) 39-43
    CrossrefPubMedGoogle Scholar
  • 54 Katotomichelakis M, Simopoulos E, Tripsianis G. , et al. Predictors of quality of life outcomes in chronic rhinosinusitis after sinus surgery. Eur Arch Otorhinolaryngol 2014; 271 (04) 733-741
    CrossrefPubMedGoogle Scholar
  • 55 Katotomichelakis M, Simopoulos E, Tripsianis G. , et al. Improvement of olfactory function for quality of life recovery. Laryngoscope 2013; 123 (11) E10-E16
    CrossrefPubMedGoogle Scholar
  • 56 Mattos JL, Schlosser RJ, Storck KA, Soler ZM. Understanding the relationship between olfactory-specific quality of life, objective olfactory loss, and patient factors in chronic rhinosinusitis. Int Forum Allergy Rhinol 2017; 7 (07) 734-740
    CrossrefPubMedGoogle Scholar
  • 57 Gottfried JA. Smell: central nervous processing. Adv Otorhinolaryngol 2006; 63: 44-69
    PubMedGoogle Scholar
  • 58 Palazidou E. The neurobiology of depression. Br Med Bull 2012; 101: 127-145
    CrossrefPubMedGoogle Scholar