Postoperative malodorous smell in open septorhinoplasty: the effect of intradomal suturing with mucosal release
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RHINOLOGY
Postoperative malodorous smell in open septorhinoplasty: the effect of intradomal suturing with mucosal release Yazeed Alghonaim1 · Abdullah S. Arafat1 · Fahad Alobaid1 Received: 7 June 2020 / Accepted: 18 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The aim of this study was to test a mucosal release method for decreasing the occurrence of malodourous smells after septorhinoplasty by preventing formation of debris pockets after surgery. Methods This study included 50 adult patients from 18 to 45 years of age who underwent open septorhinoplasty from January to May 2019. Patients were divided into two groups. The first group had intradomal (transdomal) sutures without submucosal release, while the second group had mucosal release. All patients had scheduled post-op visits at 1, 2, 4, and 8 weeks and 6 months. Results The overall postoperative rate of malodorous smell in both mucosal release and non-mucosal release patients at 2 weeks, 8 weeks and 6 months was 43.1%, 31.4% and 5.9%, respectively. Patients 36–45 years of age had a higher rate of postoperative malodorous smell with 55.6% at 2 weeks, decreasing to 33.3% at 8 weeks, and to less than 1% at 6 months. At 2 weeks after surgery, only 20% of the mucosal release group reported a malodorous smell compared to 65.4% in the nonmucosal release group. The rate was 8% at 8 weeks, and less than 1% at 6 months in the mucosal release group compared to 53.8% at 8 weeks and 11.5% at 6 months in the non-mucosal release group. Conclusions Utilizing absorbable polydioxanone sutures and releasing the vestibular mucosa of the LLC significantly reduced the rate of postoperative malodorous smell for septorhinoplasty patients with intradomal (transdomal) single-dome suturing. Keywords Septorhinoplasty · Nasal surgery · Intradomal · Sutures · Smell · Olfactory
Introduction The presence of an intact sense of smell is vital to our quality of life, appetite, psychological wellbeing and safety [1]. The integrity of olfaction depends on the patency of the nasal airflow, the olfactory neuroepithelium, and central olfactory pathways [2–5]. Smell disorders are present in up to 1% of the normal population and constitute a common problem [1].
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00405-020-06307-x) contains supplementary material, which is available to authorized users. * Abdullah S. Arafat [email protected] 1
Division of Otolaryngology Head & Neck Surgery, King Abdullah Specialized Children Hospital (KASCH), King Abdulaziz Medical City (KAMC), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia
Septorhinoplasty is one of the most common procedures in otolaryngology practice, but its effect on smell has not been well investigated [6–11]. Septorhinoplasty may alter the sense of smell in ways varying from an improvement in smell perception to its complete loss. Briner et al. showed that 2.6% of patients had a permanent change in their sense of smell afte
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