The Effect of Endoscopic Olfactory Cleft Opening on Obstructed Olfactory Cleft Disease

Rong-San Jiang, Kai-Li Liang, Rong-San Jiang, Kai-Li Liang

Abstract

Purpose: This study was conducted to evaluate the effect of endoscopic olfactory cleft (OC) opening on olfaction in patients with obstructed OC disease. Materials and Methods. Patients with obstructed OC disease who underwent endoscopic OC opening for treatment were enrolled. The endoscopic olfactory cleft opening was performed under local anesthesia. Under an endoscopy, the middle and superior turbinates were gently lateralized to open the OC using an elevator. The phenyl ethyl alcohol threshold test was performed to evaluate the olfactory function both before and after surgery.

Results: An endoscopic OC opening was performed on 42 patients. Amongst them, the etiology of OC obstruction revealed anatomic anomalies in 14 patients, inflammatory process in 14, and anatomic anomalies as well as inflammatory process in 14. The phenyl ethyl alcohol threshold levels improved in 32 (76.2%) of the patients after surgery. The olfactory function was better improved in patients experiencing OC obstructed by inflammatory process than those by anatomic anomalies.

Conclusions: This study showed that endoscopic OC opening seemed to be effective in treating olfactory dysfunction in patients with obstructed OC disease caused by inflammatory process.

Conflict of interest statement

The authors declare that there are no conflicts of interest regarding the publication of this paper.

Copyright © 2020 Rong-San Jiang and Kai-Li Liang.

Figures

Figure 1
Figure 1
(a) Obstructed olfactory cleft caused by anatomic anomalies. (b) Obstructed olfactory cleft caused by the inflammatory process. (c) Obstructed olfactory cleft caused by anatomic anomalies and inflammatory process.
Figure 2
Figure 2
(a) Preoperative endoscopic picture. (b) The right middle turbinate lateralized using an elevator. (c) The right olfactory cleft opened. (d) Edematous mucosa seen in the right olfactory cleft.

References

    1. Trotier D., Bensimon J. L., Herman P., Tran Ba Huy P., Døving K. B., Eloit C. Inflammatory obstruction of the olfactory clefts and olfactory loss in humans: a new syndrome? Chemical Senses. 2009;32(3):285–292. doi: 10.1093/chemse/bjl057.
    1. Biacabe B., Faulcon P., Amanou L., Bonfils P. Olfactory cleft disease: an analysis of 13 cases. Otolaryngology-Head and Neck Surgery. 2004;130(2):202–208. doi: 10.1016/j.otohns.2003.09.002.
    1. Vandenhende-Szymanski C., Hochet B., Chevalier D., Mortuaire G. Olfactory cleft opacity and CT score are predictive factors of smell recovery after surgery in nasal polyposis. Rhinology Journal. 2015;53(1):29–34. doi: 10.4193/rhin14.160.
    1. Shu C.-H., Lee P.-L., Shiao A.-S., Chen K.-T., Lan M.-Y. Topical corticosteroids applied with a squirt system are more effective than a nasal spray for steroid-dependent olfactory impairment. The Laryngoscope. 2012;122(4):747–750. doi: 10.1002/lary.23212.
    1. Mori E., Merkonidis C., Cuevas M., Gudziol V., Matsuwaki Y., Hummel T. The administration of nasal drops in the “Kaiteki” position allows for delivery of the drug to the olfactory cleft: a pilot study in healthy subjects. European Archives of Oto-Rhino-Laryngology. 2016;273(4):939–943. doi: 10.1007/s00405-015-3701-y.
    1. Jankowski R., Rumeau C., Gallet P., Nguyen D. T., Russel A., Toussaint B. Endoscopic surgery of the olfactory cleft. European Annals of Otorhinolaryngology, Head and Neck Diseases. 2018;135(2):137–141.
    1. Kuperan A. B., Lieberman S. M., Jourdy D. N., Al-Bar M. H., Goldstein B. J., Casiano R. R. The effect of endoscopic olfactory cleft polyp removal on olfaction. American Journal of Rhinology & Allergy. 2015;29(4):309–313. doi: 10.2500/ajra.2015.29.4191.
    1. Jankowski R., Nguyen D. T., Gallet P., Rumeau C. Olfactory cleft dilatation. European Annals of Otorhinolaryngology, Head and Neck Diseases. 2018;135(6):437–441. doi: 10.1016/j.anorl.2018.05.008.
    1. Wu S.-H., Hsu S.-H., Liang K.-L., Jiang R.-S. The effects of erythromycin towards the treatment of persistent rhinosinusitis after functional endoscopic sinus surgery. Journal of the Chinese Medical Association. 2019;82(4):322–327. doi: 10.1097/jcma.0000000000000041.
    1. Chang H., Lee H. J., Mo J.-H., Lee C. H., Kim J.-W. Clinical implication of the olfactory cleft in patients with chronic rhinosinusitis and olfactory loss. Archives of Otolaryngology—Head and Neck Surgery. 2009;135(10):988–992. doi: 10.1001/archoto.2009.140.
    1. Nguyen D. T., Gauchotte G., Arous F., Vignaud J. M., Jankowski R. Respiratory epithelial adenomatoid hamartoma of the nose: an updated review. American Journal of Rhinology & Allergy. 2014;28(5):187–192. doi: 10.2500/ajra.2014.28.4085.
    1. Krzeski A., Tomaszewska E., Jakubczyk I., Galewicz–Zielińska A. Anatomic variations of the lateral nasal wall in the computed tomography scans of patients with chronic rhinosinusitis. American Journal of Rhinology. 2001;15(6):371–375. doi: 10.1177/194589240101500603.
    1. Musy P. Y., Kountakis S. E. Anatomic findings in patients undergoing revision endoscopic sinus surgery. American Journal of Otolaryngology. 2004;25(6):418–422. doi: 10.1016/j.amjoto.2004.06.002.

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