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. 2024 Nov;281(11):5863-5871.
doi: 10.1007/s00405-024-08848-x. Epub 2024 Jul 17.

A new surgical technique to increase airflow in the olfactory cleft: superior turbinate lateralization procedure

Teru Ebihara #  1 , Kazuhiro Omura #  1 , Hironobu Nishijima  2 , Takahisa Yamamoto  3 , Nobuyoshi Otori  1 , Shu Kikuta  4
Affiliations

A new surgical technique to increase airflow in the olfactory cleft: superior turbinate lateralization procedure

Teru Ebihara et al. Eur Arch Otorhinolaryngol. 2024 Nov.

Abstract

Background: The olfactory cleft (OC) is the most important anatomical site for the maintenance of olfactory function. Obstruction of airflow in the OC by various conditions, such as inflammation, leads to poor olfactory function. Therefore, it is important to increase OC airflow while performing endoscopic sinus surgery (ESS). However, no technique to increase airflow has yet been established.

Methods: We designed a superior turbinate lateralization (STL) procedure that displaces the entire ST bone laterally by eliminating the connection between the posterior ST and the anterior wall of the sphenoid sinus. The effect of the STL procedure was investigated in terms of anatomy and olfactory function.

Results: ESS with the STL procedure was performed on seven patients with chronic rhinosinusitis and nasal polyps. The cross-sectional area of the OC at 3 months postoperatively was significantly larger than that before ESS. In addition, the Open Essence test and questionnaires revealed significantly improvements in sense of smell. Airflow in the OC was significantly higher in STL procedure group than in the non-STL procedure group.

Conclusion: The STL procedure enlarges the bony framework of the OC, and by increasing OC airflow, facilitates the transport of odorants to the olfactory epithelium, thereby improving olfactory perception.

Keywords: Nasal airflow; Olfactory cleft; Olfactory dysfunction; Olfactory epithelium; Superior turbinate.

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