Early results of transnasal endoscopic nerve transfer for olfactory neuroepithelium stimulation

Olfactory disorders affect approximately 3 to 22% of the general population and impact on human quality of life. These symptoms have gained more attention after the COVID-19 pandemic, as anosmia emerged as a common presentation. A large number of patients with smell dysfunction have exhibited limited response to clinical therapy. Therefore, we propose a transnasal endoscopic nerve transfer technique for stimulate the olfactory neuroepithelium as a potential treatment option for olfactory dysfunction. We aimed to demonstrate preliminary results of nerve transfer surgery for the treatment of olfactory disorders, as well as to present the surgical technique.

Eight patients with olfactory disorders, unresponsive to usually recommended treatments, underwent nerve transfer surgery between March 2022 and March 2023. The Connecticut olfactory test was administered to all patients before and after the surgery and quality of life was evaluated using the Visual Analogue Scale.

The average age of the patients was 46.3 years, and the olfactory disturbance has duration of approximately 27.5 months. Objective improvement in quality of life and olfactory scores was observed in 62,5% of the patients who underwent the surgery.

Transnasal endoscopic nerve transfer technique may be a promissing therapeutic method in cases of olfactory dysfunction. The follow-up of these patients over a longer period, as well as more patients undergoing nerve transfer will provide more conclusive statistical data.

Level of evidence: Level V, Therapeutic study.