The Impact of Olfactory Dysfunction on the Psychological Status and Quality of Life of Patients with Nasal Obstruction and Septal Deviation

Abstract Introduction Olfactory dysfunctionmay be present in patients with nasal obstruction and septal deviation. The impact of olfactory dysfunction on the psychological profile and quality of life (QoL) of these patients remains unexplored. Objective The present study aimed to investigate the emotional status and QoL of patients with olfactory dysfunction and septal deviation and to identify predictors associated with clinically significant improvement of psychological status and QoL, focusing mainly on the role of olfactory recovery after septoplasty. Methods The olfactory function was quantitatively assessed using the ''Sniffin' sticks'' test (Burghart Messtechnik GmbH, Wedel, Germany) in 60 patients and 25 controls enrolled in this prospective study. The participants completed validated questionnaires specific for general health (Short Form-36), nasal-symptom related QoL (SinoNasal Outcome Test-22), olfaction-associated QoL (Questionnaire of Olfactory Deficits) and for assessing their psychological state (Short Anxiety Screening Test and Beck Depression Inventory) preoperatively and 6 months postoperatively. The patients used the Glasgow Benefit Inventory to evaluate their personal benefit after septoplasty with. Results Septoplasty led to significantly improved olfactory function. Patients with olfactory impairment had significantly lower nasal-symptom related QoL, higher stress levels, andmore depressivemood compared with normosmics and controls before and after septoplasty. Postoperatively, personal benefit from surgery was higher in normosmic patients. Improvement of nasal-symptom related QoL was significantly associated with higher likelihood of clinically significant improvement of patients' psychological profile and more personal benefit from surgery. Olfactory dysfunction was negatively correlated with the emotional status of the patients. Conclusion Olfactory dysfunction appears to significantly affect the psychological status of patients with nasal obstruction, and olfactory recovery improves the patients' perception of personal benefit from septoplasty.

Long-Term Evaluation of Nasal Septoplasty Followed by Inferior Turbinate Cauterization for the Treatment of Nasal Obstruction Using Objective and Subjective Methods

Abstract Introduction Nasal septoplasty is considered the treatment of choice for nasal obstruction due to septal deviation. An ongoing discussion among rhinologists is whether it is reasonable to perform objective measurements of nasal patency pre or postoperatively routinely. Objective The primary aim of this study was to identify the short- and long-term functional benefits for patients undergoing septal surgery, as assessed by acoustic rhinometry (AR). The secondary goal was to evaluate the short- and long-term perception of symptom relief and disease-specific quality of life (QoL) outcomes on the part of the patients. Methods This was a prospective observational study in which AR was utilized for the assessment of nasal patency preoperatively and 1, 6 and 36months after septoplasty. Total 40 patients who underwent septoplasty filled out the Nasal Obstruction Septoplasty Effectiveness (NOSE) questionnaire and the Glasgow Benefit Inventory (GBI) to assess their subjective improvement in nasal obstruction symptoms and the changes in their QoL. Results There were statistically significant improvements in nasal patency, mean postoperative NOSE and GBI scores postoperatively. However, there was no correlation between the mean NOSE and GBI scores and the AR measurements. Furthermore, the GBI scores tended to decrease as the postoperative period increased. Conclusion The present study confirms that septoplasty significantly increases nasal patency and causes a significant subjective improvement in nasal obstruction symptoms. The absence of a statistically significant correlation among the objective measurements, the symptom scores, and the patients' low GBI scores indicates that factors other than the anatomical findings may also contribute to the patients' perception of QoL.

Bilateral supernumerary sternocleidomastoid heads with critical narrowing of the minor and major supraclavicular fossae: clinical and surgical implications / Cabezas supernumerarias bilaterales del músculo esternocleidomastoídeo con estrechamiento crítico de las fosas supraclavicular menor y mayor: implicancias clínicas y quirúrgicas

Anatomical variations of the sternocleidomastoid muscle are rare and concern its origin, insertion, and the number of heads. We report on a rare bilateral variant of the sternocleidomastoid muscle with aberrant and supernumerary muscular heads, observed in a cadaveric subject. On the right side of the neck, a typical sternomastoid head of the sternocleidomastoid muscle, and three aberrant clavicular heads of variable thickness, origin, and termination were noticed. On the left side, two sternomastoid heads were present; the medial one was of typical pattern, while the lateral was supernumerary. The cleidomastoid portion of the left sternocleidomastoid muscle was fused with the double sternomastoid segment. A strap-like muscle originating from the middle third of the clavicle and inserting onto the transverse process of the C3 vertebra was noticed. This is known as the cleidocervical muscle. On the right side of the neck, the posterior cervical triangle was diminished, the minor supraclavicular fossa was considerably narrow, whereas on the left, it was diminished in addition to a bilateral shortening of the major supraclavicular fossa minimizing space needed for potential surgical access. These findings are of prominent significance for anesthetists in ultrasound guided needle positioning in brachial plexus block, as well as in subclavian or external jugular vein catheterization, and in surgical interventions involving structures lying under the sternocleidomastoid muscle...

Las variaciones anatómicas del músculo esternocleidomastoideo son poco frecuentes y se refieren a su origen, inserción, y número de cabezas. Se presenta una rara variante del músculo esternocleidomastoideo con cabezas musculares aberrantes y supernumerarias bilateralmente en un cadáver. En el lado derecho del cuello, se observaron la cabeza esternomastoidea típica del músculo esternocleidomastoideo, y tres cabezas claviculares aberrantes de origen, espesor y terminación variable. En el lado izquierdo, se observaron dos cabezas esternomastoídeas, la medial con su patrón típico, mientras que el lateral fue supernumeraria. La porción cleidomastoídea del músculo esternocleidomastoideo izquierdo se fusionó con el segmento esternocleidomastoideo doble. Un músculo acintado similar procedentes del tercio medio de la clavícula e inserción en el proceso transverso de la vértebra C3 fue observado. Éste se conoce como el músculo cleidocervical. En el lado derecho del cuello, el triángulo cervical posterior fue disminuido, la fosa supraclavicular menor fue considerablemente estrecha, mientras que en el lado izquierdo, se disminuyó además a un acortamiento bilateral del espacio fosa supraclavicular importante reducir al mínimo necesario para el acceso quirúrgico potencial. Estos hallazgos tienen una importancia destacada para los anestesistas en el posicionamiento de aguja guiada por ecografía en el bloqueo del plexo braquial, así como en la cateterización de la vena subclavia o yugular externa, y en las intervenciones quirúrgicas que afecta las estructuras situadas debajo del músculo esternocleidomastoideo...