Twice-daily application of topical corticosteroids with a squirt system for patients with steroid-responsive olfactory impairment

Conclusion: Twice-daily topical corticosteroid treatment using a squirt system was beneficial in maintaining improvements in olfactory dysfunction which had been achieved by oral steroid treatment.

Objectives: Some patients suffering from olfactory dysfunction respond well to corticosteroids. However, maintaining these improvements is challenging. The aim of this study was to evaluate the maintenance effect of twice-daily topical steroid treatment using a squirt system.

Methods: Twenty-two anosmic patients with an increase in odor threshold, discrimination, and identification (TDI) scores in Sniffin’ Sticks tests by more than six points after 1-week of oral steroid treatment were enrolled. All the patients used a squirt system to apply topical corticosteroids and were followed up at 1, 3, and 6 months.

Results: Nineteen, 16, and 10 patients were followed-up at 1, 3, and 6 months after treatment, respectively. All the patients had significant visual analog scale scores improvements compared to pre-treatment. The mean improvements in TDI scores were 9.80 (p?p?=?0.001), and 13.87 (p?=?0.005) after 1, 3, and 6 months of treatment, respectively. The self-rated and objective olfactory function scores were maintained with steroid squirt therapy without significant decline, even in the patients who were followed up for 6 months.     

上呼吸道感染后嗅觉障碍患者脑形态学与嗅觉功能相关性分析

目的 通过探究上呼吸道感染后嗅觉障碍脑灰质形态变化,得出上呼吸道感染后嗅觉障碍患者嗅觉中枢结构的影像学特点。方法 选取上呼吸道感染后嗅觉障碍的患者24例与嗅觉功能正常的健康对照受试者20例,通过基于体素的大脑皮质形态学体积测量(VBM)比较患者的大脑灰质和白质体积与对照组的差异。结果 上呼吸道感染后嗅觉障碍组患者TDI[气味察觉阈(T)、气味辨别能力(D)、气味识别能力(I)]总分(16.45±5.62)分,T为(2.33±0.93)分,D为(6.54±2.60)分,I为(7.58±3.22)分;嗅觉障碍平均时长为(19.00±6.33)个月;视觉模拟量表评分(VAS)为(7.79±2.41)分,与对照组比较均存在统计学差异(P<0.05)。上呼吸道感染后嗅觉障碍患者的大脑灰质总体积和嗅皮质体积明显小于对照组(P<0.05),大脑灰质总体积占全脑体积的比例和皮质厚度与嗅觉功能评分TDI值呈正相关(r=0.71,P<0.000 1;r=0.69,P=0.000 9)。结论 上呼吸道感染后嗅觉障碍患者大脑灰质总体积和嗅皮质体积减少,且嗅觉功能与大脑灰质体积比例及皮质厚度呈...     

Analysis of the clinical effect of olfactory training on olfactory dysfunction after upper respiratory tract infection

Background: Olfactory dysfunction is a common symptom during otolaryngology outpatient service.

Objective: To explore the clinical effect of olfactory training on olfactory dysfunction after upper respiratory tract infection (URTI), and its influence factors.

Material and methods: A total of 60 confirmed cases of URTI-induced olfactory dysfunction were enrolled into the present study. The olfactory training lasted for 24 weeks. These patients were tested using Sniffin’ Sticks and threshold-discrimination-identification (TDI) composite scoring before treatment, and at 1, 3 and 6 months after treatment.

Results: It was found that URTI-induced olfactory dysfunction patients had more evident deterioration in odor identification ability. The effective rates of olfactory training on olfactory dysfunction at 1, 3 and 6 months after treatment were 1.67%, 26.67% and 41.67%, respectively. The TDI scores at the 3rd and 6th months, but not at the 1st month, were significantly higher, when compared to those before treatment. The course of diseases was a significant influence factor on the therapeutic effect of olfactory training (OR = 0.805, 95% CI: 0.696–0.931).

Conclusions: Olfactory training can efficiently cure URTI-induced olfactory dysfunction, and in particular, significantly improve the odor discrimination ability and odor identification ability.

Significance: Providing useful data for further research regarding olfactory dysfunction.     

The impact and prospect of traumatic brain injury on olfactory function: a cross-sectional and prospective study

Traumatic brain injury (TBI) can cause olfactory loss. The aim of this cross-sectional and prospective study was to determine the prevalence of olfactory loss among 110 patients with TBI within 3 months after the trauma. In 81 patients (“cross-sectional”-group), olfactory function could be measured using the validated “Sniffin’ Sticks” test for odor threshold and odor identification. In addition, the prospective change of olfactory function was studied in 36 patients (“follow-up”-group) by means of a validated odor threshold, discrimination and identification test. Olfactory function was significantly better in patients with TBI I° compared to individuals with TBI II° and III°. Clinically significant improvement of olfactory function was found in 36 % of the patients, most frequently during the first 6 months after the injury, in a median follow-up interval of 21 months. TBI I° has in general no major effect on olfaction. In contrast, patients with TBI II° and III° exhibit smell loss in 57 %. Chances for olfactory recovery were highest within the first 6 months after the trauma.     

The effect of smoking on the olfactory function

Although smoking is a widely spread habit, its effect on olfaction has not been clearly established. The aim of this study was to investigate the effect of cigarette smoking on the olfactory function, using the "Sniffin' Sticks" test. Sixty-five smokers were studied, with a median period of smoking of 10 years (range: 1-45 years) and a median number of 15 cigarettes smoked per day (range: 5-20). Forty-nine non-smokers were used as controls. Olfactory function was evaluated using the "Sniffin' Sticks" test, which consists of odour threshold (OT), odour discrimination (OD) and odour identification (OI) and its overall results may be presented as a composite threshold-discrimination-identification (TDI) score. Multivariate linear and logistic regression analyses were performed. All OT, OD, OI and TDI scores were statistically significantly lower in smokers compared to non-smokers, even when controlled for gender and age. Low OT, OD, OI and TDI scores were more prevalent among smokers than non-smokers. Multivariate logistic regression analysis, adjusted for gender and age, revealed that smoking remained a strong independent risk factor for low OT, OD, OI and TDI scores. Among smokers, statistically significant negative relationships were found between pack-years and OT, OD, OI and TDI, controlling for age. In conclusion, smoking was found to be adversely associated with the olfactory ability in a dose-related manner. Smokers were found to be nearly six times as likely to evidence an olfactory deficit as non smokers, depending on the duration and the amount of cigarettes smoked.     

Olfactory training for patients with olfactory loss after upper respiratory tract infections

Olfactory training consisting of daily suprathreshold odor exposure over 12 weeks seems to improve olfactory function. It is unknown if a longer period of training might be more effective. A prospective non-randomized clinical study was performed including 39 patients with olfactory loss after an upper respiratory tract infection (URTI) of less than 24 months duration. Patients exposed themselves with suprathreshold concentrations of four odors (rose, eucalyptus, lemon, cloves) applied in ‘‘Sniffin’ Sticks’’ felt-tip pens over 32 weeks. Olfactory function was performed before (T1), after 16 weeks (T2), and 32 weeks of training (T3) using the ‘the Sniffin’ Sticks test kit calculating the TDI score (Threshold, Discrimination, Identification). The mean TDI score showed a non-significant trend of improvement at T2, and was significantly increased at T3 (p = 0.021). Overall, 31 patients (79 %) showed an increased TDI score at T3. The increase of TDI from T1 to T3 was 4.6 ± 5.1. Age, gender, duration and initial severity of olfactory loss had no influence on the improvement (all p > 0.05). Only patients with a D score lower than the median value of 8 showed a significantly higher increase of the D score at T3 (p = 0.004). The present study confirmed that olfactory training improves olfactory function in patients with olfactory loss after URTI. A longer duration of training over 32 weeks seems to increase the effectiveness in comparison to a 12-week period. This was tested in a completed German multicenter trial to be published soon containing a control group to include the effect of a spontaneous recovery after URTI.     

Intravenous olfactory test latency correlates with improvement in post-infectious olfactory dysfunction

Conclusion: This cohort study showed that onset latency in the intravenous olfactory test (IVO) may help predict when olfaction in patients with post-infectious olfactory dysfunction (PIOD) improves.

Objectives: To identify factors that predict the olfactory improvement period in patients with PIOD.

Methodology/Principal: All consecutive patients presenting with PIOD in 1994–2014 who were followed up for 2 years were identified retrospectively. The ability of demographic/clinical factors (age, sex, body mass index, presence/absence of allergic rhinitis, treatment/non-treatment with herbal medicines, patient dependence on herbal medicine treatment, presence/absence of diabetes mellitus, and smoking status) and olfactory test factors (response/no response and onset latency and duration in the IVO test, and detection and recognition scores on the T&;T olfactory test) to predict the olfactory improvement period (defined respectively as the time from PIOD onset or olfactory testing to the first self-report of olfaction improvement) was analyzed by univariate and multivariate regression.

Results: Of the 187 PIOD patients, the prognostic ability of demographic/clinical factors was analyzed in 65. None predicted the olfactory improvement period. Of the 65 patients, 20 did not respond in the IVO test. In the remaining 45 patients, onset latency (but not the other olfactory test factors) was a significant prognosticator of olfactory improvement period (R²=0.24, p?=?0.003).     

Postoperative evaluation of olfactory dysfunction in eosinophilic chronic rhinosinusitis – comparison of histopathological and clinical findings

Abstract

Background: Olfactory dysfunction in eosinophilic chronic rhinosinusitis (ECRS) is poorly understood.

Objective: To compare olfactory mucosal injury due to eosinophil infiltration in ECRS with postoperative olfactory function.

Methods: Seventeen ECRS patients (ECRS group) and 18 bilateral rhinosinusitis (non-ECRS group) patients were compared. At 3 and 12 months post-endoscopic sinus surgery (ESS), all patients were evaluated for subjective symptoms (nasal obstruction, nasal discharge and olfactory dysfunction), endoscopic nasal findings, CT score and T&T olfactometer recognition threshold test. The eosinophil count, OMP-positive cells and epithelial erosion in olfactory mucosa collected during ESS were compared with the postoperative olfactory function.

Results: The non-ECRS group showed significant improvement in all clinical findings at 3 and 12 months, but the ECRS group showed worsening of the olfactory dysfunction symptoms and T&T olfactometer recognition threshold at 12 months because of recurrence of sinusitis. The groups differed significantly in the ΔT&T value (i.e. pre-ESS T&T recognition threshold – post-ESS T&T recognition threshold) at both 3 and 12 months, and the degree of olfactory improvement differed. Histologically, the ECRS group showed significantly more eosinophils, fewer OMP-positive cells and greater epithelial erosion than the non-ECRS group.

Conclusions: Eosinophilic inflammation was thought to cause olfactory mucosal injury/dysfunction.     

Effects of Olfactory Training in Patients With Postinfectious Olfactory Dysfunction

ObjectivesPostinfectious olfactory dysfunction (PIOD) is the most common etiology of olfactory dysfunction, and olfactory training (OT) is an accepted treatment modality for PIOD. Some studies have investigated OT in Korean patients, but they involved odorants unfamiliar to Koreans or had no control group. The aim of this study was to verify the efficacy of OT in PIOD patients, using odorants familiar to Koreans and including a control group.MethodsWe enrolled a total of 104 Korean patients with PIOD over the 3-year study period. All participants were assessed using endoscopy and an olfactory function test at the baseline assessment and 3 months after OT. The olfactory function test was performed using the Korean version of Sniffin’ stick (KVSS) II. Nasal and psychological function was evaluated using a visual analog scale and the Mini-Mental State Examination. OT was performed over a period of 3 months, using five odorants (rose, lemon, cinnamon, orange, and peach).ResultsOT improved olfactory function in approximately 40% of subjects over a period of 12 weeks compared to non-OT subjects. A comparison of changes between the initial and follow-up assessments demonstrated that the OT group had significantly better olfactory results for the total KVSS II, threshold, and identification scores than the non-OT group. The degree of olfactory improvement after OT was affected by the initial score.ConclusionThe effects of OT in patients with PIOD were demonstrated in this study. A meaningful contribution of this study is that Korean patients were tested using odors familiar to them in comparison with a control group.     

Active olfactory training for the treatment of smelling disorders

Olfactory function appears to be influenced by repeated odor stimulation. We conducted a nonrandomized, nonblinded, retrospective study of the impact of an 8-month period of olfactory training in patients with olfactory dysfunction. Our study population was made up of 46 adults-14 men and 32 women (mean age: 59.17 ± 13.25 yr)-with olfactory dysfunction of different etiologies (sinonasal: n = 15; post-upper-respiratory-tract infection [URTI]: n = 16; post-traumatic: n = 7; and idiopathic: n = 8). All patients had been previously treated without success with systemic or topical corticosteroids. For their training, patients exposed themselves to four different odors twice a day. Olfactory function was evaluated at baseline and again at 4 and 8 months, and results were quantified in the form of each patient's TDI (threshold, discrimination, and identification) score. Of the 46 patients, 28 had undergone olfactory training only, while the remaining 18 had received topical corticosteroids in addition to training. At study's end, the mean overall TDI score in the entire group increased by 4.09 points over baseline--a statistically significant increase (p = 0.01); this increase was mainly attributable to improvement in the identification component of the TDI, which increased by 2.51 points (p = 0.02). Among the 18 patients who received a topical corticosteroid in addition to training, the mean TDI increased by 6.83 points (p = 0.001), primarily because of improvements in the discrimination and identification components. The 28 patients who underwent olfactory training alone experienced a mean increase in the identification component of only 2.20 points (p = 0.14) after 8 months. Olfactory function in the post-URTI patients increased significantly at 4 months. We conclude that olfactory discrimination and identification can be enhanced by the addition of a topical corticosteroid to a program of defined, daily, short-term exposure to olfactory training.     

深圳小学高年级学生嗅觉功能的初步调查及与成绩的相关性初探

目的 探讨SniffinSticks在儿童嗅觉功能检查中的应用可行性。 方法 2015年4月至7月采用SniffinSticks法检测嗅觉正常的深圳某小学五、六年级小学生共70名,比较嗅觉评分与期末考试各科成绩的相互关联,探讨嗅觉记忆与学习能力的可能联系。 结果 选取对象中五年级30名,男17名,女13名;六年级40名,男22名,女18名。70名学生的SniffinSticks正常参考值是:气味阈值(OT):10.95±2.7,气味辨别值(OD):12.92±1.0,气味鉴别值(OI):13.74±1.6;嗅觉功能总分(TDI):37.54±2.2。男女间OT、OD、OI、TDI值差异无统计学意义,五、六年级间OT、OD、OI、TDI值差异亦无统计学意义。OT、TDI与英语成绩呈负相关(P<0.01)。 结论 SniffinSticks嗅觉检测方法能被较大儿童理解和接受,可用于儿童嗅觉测试。高年级男女学生嗅觉功能差异无统计学意义。     

Comparison of the effects of nasal steroids and montelukast on olfactory functions in patients with allergic rhinitis

Objective

Olfactory dysfunction is one of the comorbidities associated with allergic rhinitis (AR) and AR is one of the common causes of olfactory problems. We aimed to evaluate by the Sniffin’ Sticks test the effects on olfactory functions of nasal steroids and leukotriene antagonists used for allergic rhinitis.

Development of a murine model of traumatic benign paroxysmal positional vertigo: a preliminary study

Conclusion: The results showed a gradual detachment of otoconia in the utricle after a single event of head vibration, possibly explaining the frequent recurrence of BPPV attacks and persistent dizziness after trauma.

Objectives: This study developed a murine model of traumatic BPPV and observed the changes in otoconia detachment over time.

Methods: Six-week-old CBA mice were used in this study. Otoconia detachment was induced by vibrating the head for 2?min. Utricles of mice were harvested from different groups: before the head vibration and 1?day, 1 week, 1 month, and 3 months after vibration application. Using scanning electron microscopy and ImageJ software, the percentage of the intact area of otoconia in the utricle was calculated. Hearing thresholds were compared among the groups.

Results: The mean (±?SD) percentages of the intact area of otoconia in the utricle were 98.1%?±?1.7% before the vibration and 93.6%?±?1.7%, 88.9%?±?5.3%, 78.2%?±?20.9%, and 38.9%?±?24.1% at 1?day, 1 week, 1 month, and 3 months after the vibration, respectively. The percentage decreased significantly over time after the vibration (p?相似文献   

The olfactory function in patients with common variable immunodeficiency

AimsTo determine the incidence of olfactory dysfunction in common variable immunodeficiency patients. To evaluate the correlation between olfactory dysfunction and chronic rhinosinusitis in this class of patients.Materials and methodsFifty patients, with a diagnosis of common variable immunodeficiency and under immunoglobulin replacement therapy, were submitted to an otolaryngology physical examination and a CT scan of the craniofacial structures in order to show the presence of signs of chronic rhinosinusitis. An olfactory function evaluation was executed using the Sniffin’ Sticks Test, with assessment of olfactory threshold, discrimination, identification and overall composite scores (TDI: threshold-discrimination-identification score).ResultsAn olfactory dysfunction was found in 23 (46%) common variable immunodeficiency patients, with hyposmia and anosmia respectively present in 65% and 38% of them. The mean TDI score in the study group was 27.7. Common variable immunodeficiency patients with CRS presented a more suggestive increase of the olfactory threshold, discrimination and identification compared to those without chronic rhinosinusitis.ConclusionIn conclusion, patients with common variable immunodeficiency seem to suffer from olfactory disorders more than healthy people. One of the causal factors could be considered the presence of rhinosinusal pathologies.     

Assessment of the efficacy of a local steroid rescue treatment administered 2 days after a moderate noise-induced trauma in guinea pig

Objectives: Intratympanic injection of corticosteroids membrane after noise-induced hearing loss is an accepted alternative to general administration. We investigated the effect on hearing of a hyaluronic acid gel with liposomes loaded with dexamethasone (DexP) administered into the middle ear.

Methods: An acute acoustic trauma was performed to 13 guinea pigs for a period of 1?h on Day ?2. Two 2 days after the noise trauma, the animals were then assigned randomly to four experimental groups: control without gel, gel injection, gel-containing free DexP, gel-containing DexP loaded into liposomes. Auditory thresholds were measured with Auditory Brainstem Response before Day ?2 and at Day 0, Day 7 and Day 30 after noise trauma.

Results: Seven days after, a complete hearing recovery was observed in the control group at all frequencies apart from 8?kHz, and no recovery was observed in the three groups receiving a gel injection. Thirty days after trauma, all of the animals had recovered normal hearing, apart from at the 8-kHz frequency, with similar auditory thresholds.

Conclusions: Local DexP administration 48?h after a mild acoustic trauma did not improve hearing recovery, even with a sustained release in a specific gel formulation designed for inner ear therapy.     

Clinical features of olfactory dysfunction in elderly patients

ObjectiveThis study aimed to investigate the causes of olfactory dysfunction (OD) and to discuss the benefits of understanding the characteristics of OD in elderly patients.MethodsA total of 4300 patients with OD who were treated at our hospital between January 1996 and December 2020 were retrospectively analyzed. There were 1833 men and 2467 women, with ages ranging from 4 to 95 years. The patients were divided into two groups: younger (less than 65 years old, n = 2947) and elderly (65 years old or more, n = 1353) groups. Causative diseases were chronic rhinosinusitis (CRS), post-viral (PV), post-traumatic (PT), central nervous system dysfunction (CNS), peripheral nervous system dysfunction (PNS), congenital, psychogenic, and unknown. Visual analogue scale (VAS) and olfactory detection and recognition thresholds using the T&T olfaction test were used to evaluate olfaction. The mean detection and recognition thresholds, as well as the deviation difference (the difference between the mean detection and recognition thresholds) were compared by causative disease.ResultsThe causative diseases in elderly group were CRS (32%), PV (28%), PT (3%), CNS (2%), and PNS (4%). OD of unknown cause was significantly more in elderly (30%) than in younger patients (12%). Olfactory detection and recognition thresholds in elderly group were significantly worse than in younger group (p < 0.05). The olfactory detection and recognition thresholds were not any significant differences between patients with OD of unknown cause and those with CNS.ConclusionOD of unknown cause was predominantly observed in elderly group. The olfactory acuity of OD of unknown cause was similar to CNS OD. These findings suggest the importance of continuous follow-up due to the potential of neurodegenerative diseases in elderly OD patients.     

Hunger state affects both olfactory abilities and gustatory sensitivity

Chemical senses such as odor, taste and appearance are directly related with appetite. Understanding the relation between appetite and flavor is getting more important due to increasing number of obese patients worldwide. The literature on the studies investigating the change in olfactory abilities and gustatory sensitivity mostly performed using food-related odors and tastes rather than standardized tests were developed to study olfaction and gustation. Therefore, results are inconsistent and the relationship between olfactory and gustatory sensitivity with respect to the actual state of human satiety is still not completely understood. Here, for the first time in literature, we investigated the change in both olfactory abilities and gustatory sensitivity in hunger and in satiety using 123 subjects (37 men, 86 women; mean age 31.4 years, age range 21–41 years). The standardized Sniffin’ Sticks Extended Test and Taste Strips were used for olfactory testing and gustatory sensitivity, respectively. TDI score (range 1–48) was calculated as the collective scores of odor threshold (T), odor discrimination (D) and odor identification (I). The evaluation was performed in two successive days where the hunger state of test subjects was confirmed by blood glucose test strips (mean blood glucose level 90.0 ± 5.6 mg/dl in hunger and 131.4 ± 8.1 mg/dl in satiety). The results indicated statistically significant decrease in olfaction in satiety compared to hunger (mean TDI 39.3 ± 1.1 in hunger, 37.4 ± 1.1 in satiety, p < 0.001). The comparison of gustatory sensitivity indicated significantly higher sensitivity to sweet, sour and salty in hunger (p < 0.001), but significantly higher sensitivity to bitter tastant in satiety (p < 0.001). With this prospective study, we were able to show that both olfactory abilities and gustatory sensitivity were affected by hunger state.     

Correlation between olfactory severity ratings based on olfactory function test scores and self-reported severity rating of olfactory loss

Conclusion: Olfactory test scores are significantly correlated with self-rated severity scales. However, the statistical rating based on olfactory tests did not strongly agree with the self-reported severity rating. This suggests that there is a discrepancy between olfactory test results and the severity described by patients themselves.

Objectives: This study aimed to identify the correlation between statistical ratings based on test scores and self-rating of the severity of olfactory loss.

Method: A total of 1555 subjects were asked to rate olfactory loss severity by one of five scales. Olfactory tests consist of the butanol threshold test (BTT) and cross-cultural smell identification test (CCSIT).

Results: There were significant correlations between BTT scores and self-rated severity scales (r?=?0.619, p?r?=?0.597, p?p?p?相似文献   

An assessment of olfactory function in patients with laryngopharyngeal reflux disease

Conclusions: The results reported here indicate that there was a statistically significant difference in the olfactory functions of laryngopharyngeal reflux patients vs the healthy group. To the best of the authors’ knowledge, this study is the first to evaluate the olfactory function of patients diagnosed with laryngopharyngeal reflux using an objective method, 24-h pH monitoring.

Objectives/Hypothesis: The aim of this study was to investigate olfactory functions in laryngopharyngeal reflux (LPR) patients and compare the results with healthy controls.

Methods: A total of 60 participants; 30 men and women with a diagnosis of laryngopharyngeal reflux and 30 healthy controls, were included in the study. Patients in the laryngopharyngeal reflux group were evaluated by the Reflux Symptom Index (RSI), Reflux Finding Scores (RFS), and finally 24-h pH monitoring to confirm the diagnosis of laryngopharyngeal reflux. The Sniffin’ Sticks olfactory test results of the laryngopharyngeal reflux and control groups were compared, and the relationship between the study findings and the olfactory parameters were evaluated.

Results: The odor threshold, odor discrimination, odor identification, and TDI scores of the laryngopharyngeal reflux group were significantly lower than those of the control group. Also there was a statistically significant negative correlation detected between the olfactory test and some symptom and finding scores.     

Assessment the long-term effects of septoplasty surgery on olfactory function

Objectives: This research aimed to evaluate pre-operatively and post-operatively the olfactory function of patients who had undergone surgery in our clinic for chronic nasal blockage via the Connecticut Chemosensory Clinical Research Center (CCCRC) smell test.

Method: Thirty-seven patients (24 females, 13 males) were enrolled in this study. All had undergone surgery in our clinic due to chronic nasal blockage (not for smell dysfunction), having been diagnosed with septal deviation in conjunction with concha bullosa and/or inferior turbinate hypertrophy. This is a prospective study without a control group. The mean age was 33.74?±?8.98 (range =19–54). All of the operations were performed under general anesthesia. CCCRC smell tests were performed on every patient before the operation and at post-operative 1st week, 6th week, 6th month, and 1st year.

Results: In this study, we found that septoplasty, in conjunction with middle concha surgery and/or inferior concha radiofrequency, did not affect the olfactory function negatively.

Conclusion: Although nasal surgery has the potential to affect the smell function negatively, it was found that olfactory function was not affected after the surgery during a considerably long follow-up period. Moreover, an improvement in smell function was detected at post-operative 6th month and 1st year.