Olfactory Dysfunction and its Course in Patients With Nasal Bone Fracture.

Abstract

Nasal bone fractures are the most common facial bone fractures. Although olfactory dysfunction is one of the most common complications in patients with nasal bone fractures, few studies on olfactory dysfunction in nasal bone fractures have been reported. The authors attempted to find the frequency and course of olfactory dysfunction and hypothesize its mechanism in patients with nasal bone fractures. Sixty-six patients who underwent closed reduction were examined using the Korean version of Sniffin' Sticks test (KVSS) II at preoperation, 1 month and 6 months postoperation. We categorized 30 points or more as "normosmia," 15 points or less as "anosmia," and the scores between them as "hyposmia." The authors only performed test in patients who subjectively complained of their loss of sense of smell at 1 and 6 months postoperation. The authors classified the patients as "olfactory dysfunction" or "normal olfaction" using the Threshold-Discrimination-Identification score and subjective complaint of symptom. Olfactory dysfunction was seen on 31 of 66 patients (46.9%) preoperatively. Twenty-four patients (36.3%) showed olfactory dysfunction at 1 month postoperation, and 4 patients (6.0%) showed olfactory dysfunction at 6 months postoperation. Twelve of the 35 patients (34.3%) with normosmia shown in the preoperation had new olfactory dysfunction after the surgery. Olfactory dysfunction is common complication in nasal bone fracture. However, this complication was recovered in most cases (93.9%). In addition, patients should receive explanations about the possibility of iatrogenic olfactory impairment after surgery, and a gentle maneuver is helpful for preventing iatrogenic damage.