ĐÁNH GIÁ KHỨU GIÁC TRƯỚC PHẪU THUẬT CHỈNH HÌNH VÁCH NGĂN

Abstract

Introduction: Among the symptoms caused by septal deviation, hyposmia is often overlooked by both patients and ENT specialists. However, recent studies have shown that olfactory disorders significantly affected quality of life. Therefore, olfactory function in patients with septal deviation should also be actively assessed and appropriately controlled. Methods: A case series study conducted on patients with hyposmia and indicated with septoplasty at the University Medical Center Ho Chi Minh City from October 2024 to June 2025. Clinical features, sinus CT scans, active anterior rhinomanometry, and Sniffin’ Sticks Test were collected and analyzed. Results: Among the 27 patients studied, the mean age was 37.56 ± 10.64 years. The male-to-female ratio was 66.7% and 33.3%, respectively. Left-sided septal deviation was more common than right-sided (55.6% vs. 44.4%). Based on Mladina's classification of septal deviations, no surgical cases fell into type 1 or type 6. Type 7 had the highest proportion (40.7%), followed by type 5 (29.6%). Types 2 and 3 each accounted for 11.1%, and type 4 accounted for 7.4%. Inferior turbinate hypertrophy was present in 96.3% of cases. Isolated septal deviation was diagnosed in 3.7%, while septal deviation with bilateral inferior turbinate hypertrophy was found in 96.3%. The isolated septal deviation case had reduced smell. Among the patients with septal deviation and bilateral turbinate hypertrophy, 61.5% had normal olfaction, 34.6% had hyposmia, and 3.9% had anosmia. The average bilateral nasal airway resistance was 0.688 ± 0.625; the rate of bilateral nasal obstruction was 3.7%, at a moderate level. The average scores for the olfactory threshold (T) were 7.05 ± 3.69, odor discrimination (D) 11.18 ± 2.61, and odor identification (I) 11.22 ± 2.25. The median total TDI score was 31.75 (range: 15–37.5). The rates of olfactory impairment in the threshold, discrimination, and identification tests were 29.6%, 48.1%, and 59.3%, respectively. Based on age-adjusted TDI scores, 3.7% had anosmia, 37% had hyposmia, and 59.3% had normal olfaction. Using the ideal TDI score thresholds, mild and moderate hyposmia were each observed in 18.5%, severe in 7.4%, and very severe in 3.7%. Among patients without nasal obstruction, 3.9% had anosmia, 34.6% had hyposmia, and 61.5% had normal olfaction. All patients with moderate nasal obstruction had mild hyposmia. Among those without nasal obstruction, 15.4% had mild, 19.2% had moderate, 7.7% had severe, and 3.9% had very severe hyposmia. Conclusion: There was no correlation between the changes in nasal airflow dynamics and the degree of olfactory dysfunction in patients before septoplasty.