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Meta-Analysis
. 2025 Jan-Dec:54:19160216251351566.
doi: 10.1177/19160216251351566. Epub 2025 Jun 27.

Partial Middle Turbinate Resection Versus Preservation on Olfactory Function: A Systematic Review and Meta-Analysis

Yen-An Chen  1 , Chih-Hao Chen  1   2   3   4 , Wei-Hsin Wang  2   5 , Ming-Ying Lan  1   2
Affiliations
Meta-Analysis

Partial Middle Turbinate Resection Versus Preservation on Olfactory Function: A Systematic Review and Meta-Analysis

Yen-An Chen et al. J Otolaryngol Head Neck Surg. 2025 Jan-Dec.

Abstract

ObjectivesThe middle turbinate (MT) was considered related to olfactory function. Whether the MT should be partially resected during relevant surgery is still debated. Our primary objective was to compare the olfactory outcome between partial MT resection (MTR) and MT preservation (MTP).MethodsA search was performed on the Cochrane Library, Embase, PubMed, Scopus, and Web of Science databases from their inception through February 10, 2024. Eligible studies included those that compared the olfactory outcome between partial MTR and MTP. Data were extracted manually, and a random-effects model was used to evaluate it. We calculated the standardized mean differences (SMD) in the scores for the olfactory function. Further subgroup analysis was also performed for variables of interest. The pooled results were examined using influence analysis.ResultsAfter systematically reviewing all relevant articles, 7 studies were qualified for inclusion. The pooled results showed no significant difference in olfaction between the partial MTR and MTP (SMD, 0.140; 95% CI, -0.159 to 0.438; P = .359; I2 <1%). Subgroup analysis preferred partial MTR in the objective test (SMD, 0.370; 95% CI, 0.17-0.56; P < .001; I2 = 0%). No significance was observed in studies with subjective test (SMD, -0.271; 95% CI, -0.604 to 0.63; P = .112; I2 <1%), undergoing functional endoscopic sinus surgery (0.10; 95% CI, -0.35 to 0.54; P = .67; I2 = 85%), undergoing skull base surgery with endoscopic endonasal approach (SMD, 0.25; 95% CI, -0.04 to 0.53; P = .09; I2 = 0%), and following up more than 6 months (SMD, 0.09; 95% CI, -0.21 to 0.39; P = .57; I2 = 75%).ConclusionOur findings showed that MTR does not deteriorate olfactory function compared with MTP. Considering the potential benefit, partial MTR might be prioritized in clinical settings.

Keywords: endoscopic endonasal approach; functional endoscopic sinus surgery; middle turbinate preservation; middle turbinate resection; olfactory function.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Graphical Abstract
Graphical Abstract
Figure 1.
Figure 1.
PRISMA flow diagram. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2.
Figure 2.
Overall effect of the comparison between MTP and MTR. MTP, middle turbinate preservation; MTR, middle turbinate resection; SMD, standardized mean difference; CI, confidence interval; IV, inverse variance.
Figure 3.
Figure 3.
Subgroup analysis by the olfactory test method. SMD, standardized mean difference; CI, confidence interval; IV, inverse variance.
Figure 4.
Figure 4.
Subgroup analysis by surgery type. SMD, standardized mean difference; CI, confidence interval; IV, inverse variance.
Figure 5.
Figure 5.
Subgroup analysis by follow-up length. SMD, standardized mean difference; CI, confidence interval; IV, inverse variance.
Figure 6.
Figure 6.
Influence analysis of the overall results. CI, confidence interval; IV, inverse variance; SMD, standardized mean difference.
Figure 7.
Figure 7.
Sensitivity analysis excluding high risk of bias studies. SMD, standardized mean difference; CI, confidence interval; IV, inverse variance.
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