Publication

Trigeminal endonasal perception - an outcome predictor for septoplasty

Journal Paper/Review - Oct 1, 2020

Units
PubMed
Doi

Citation
Bischoff S, Poletti S, Kunz S, Kiessling S, Hinder D, Dreher A, Akdis C, Soyka M. Trigeminal endonasal perception - an outcome predictor for septoplasty. Rhinology 2020; 58:437-443.
Type
Journal Paper/Review (English)
Journal
Rhinology 2020; 58
Publication Date
Oct 1, 2020
Issn Print
0300-0729
Pages
437-443
Brief description/objective

BACKGROUND
No adequate test exists to predict outcome after septoplasty. Despite adequate surgery, patients still might experience nasal breathing impairment. The aim of this study was to determine if pre-operative trigeminal sensitivity can predict satisfaction after septoplasty.

METHODS
Single centre prospective cohort study in tertiary referral centre with follow-up time of 6 weeks postoperatively. Patients scheduled for septoplasty or septorhinoplasty with turbinoplasty were consecutively selected the day before surgery. Standard preoperative examinations (acoustic rhinometry and Sniffin’ Sticks 12 test), the evaluation of nasal obstruction on a visual analogue scale (VAS) and the trigeminal lateralisation task were performed before and 6 weeks after surgery. Biopsies were taken during surgery and TRPV1 mRNA expression was measured by PCR.

RESULTS
Thirty patients were included with a median age of 29 years and equal gender distribution. Trigeminal perception and sensation of nasal obstruction showed a significant correlation: preoperative lateralisation test scores, representing endonasal trigeminal sensitivity, correlated significantly with the mean VAS change scores, which demonstrate subjective improvement. A lateralisation test score of 31.5 and more had a sensitivity of 88% to predict an improvement of more than 3 VAS points. Additionally, high TRPV1 mRNA expression was linked with good postoperative VAS scores.

CONCLUSION
The preoperative evaluation of the trigeminal sensitivity could improve patients’ selection for septoplasty with a higher rate of satisfaction. Endonasal trigeminal sensitivity is directly linked with subjective outcome. Therefore, patients with low trigeminal sensitivity should undergo septoplasty only after thorough counselling.