Quality of life and olfactory outcomes following frontal sinus drill-out procedures

• Published in: American journal of otolaryngology Vol. 44; no. 1; p. 103651
• Main Authors: Başak, Hazan, Rehan, Moustafa, Yücel, Levent, Beton, Süha, Meco, Cem, Yorulmaz, Irfan
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2023; Elsevier Limited
• Subjects: Bone surgery; Chronic Disease; Chronic rhinosinusitis; Disease; Draf procedures; Endoscopic sinus surgery; Endoscopy; Endoscopy - methods; Frontal Sinus - surgery; Frontal sinusitis; Humans; Morbidity; Odor thresholds; Odors; Olfaction; Olfactory discrimination; Olfactory discrimination learning; Olfactory epithelium; Olfactory thresholds; Otolaryngology; Patients; Polyps; Quality assessment; Quality of Life; Questionnaires; Rhinitis; Rhinosinusitis; Sinuses; Sinusitis; Smell; Statistical analysis; Surgery; Treatment Outcome; Draf procedures; Chronic rhinosinusitis; Frontal sinusitis; Endoscopic sinus surgery; Olfaction
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2022.103651

Extensive endoscopic frontal sinus surgery requires drilling of the bone close to the olfactory epithelium and exposing the first olfactory fiber. This study assesses long-term quality of life (QoL) and olfactory outcomes following endoscopic endonasal frontal sinus drill-out procedures. All patients who underwent endoscopic endonasal frontal sinus surgery (Draf IIa or Draf III) for chronic rhinosinusitis (CRS) without nasal polyp in 2017 at a single tertiary center were included in the study. Pre- and postoperative scores of SNOT-22, odor identification, discrimination, and threshold were noted. Of the 31 patients included in this study, Draf IIa and Draf III were performed in 12 (38.7 %) and 19 (61.3 %) patients, respectively. A general assessment of QoL changes was carried out by evaluating pre- and postoperative SNOT-22 scores. A statistically significant difference was found between pre- and postoperative SNOT scores (p < 0.001): SNOT scores decreased by 9.13 units postoperatively. Comparing differences in SNOT-22 and olfactory test scores between Draf IIa and Draf III patients, we did not detect any statistically significant difference between the two procedures (p > 0.05). Draf IIa and Draf III did not display a statistically significant difference in SNOT-22 scores (p = 0.484) and did not have a significant effect on differences in pre- and postoperative identification (p = 0.675), discrimination (p = 0.535), and threshold (p = 0.141) scores. Our study demonstrated that extensive drill-out procedures have not a negative effect on olfactory functions, including threshold scores, in the long term. Patients who underwent frontal sinus procedures for persistent CRS have a better QoL postoperatively. However, more prospective double-blind studies are needed to support our results.