Læknablaðið : fylgirit - 01.06.2005, Blaðsíða 18

ABSTRACTS / XXIX CONGRESS OF THE NORDIC ASSOCIATION OF OTOLARYNGOLOGY
O-ll NASAL AIRFLOW AND CHEMICAL SENSES
Abstract no.: 024
National quality register for Septoplasty-surgery in Sweden
- a continuous improvement of the outcome through opti-
mized patient information and a uniform standardized surgi-
cal process
Kumlien J, ENT-clinic Karolinska Solna, Bohlin L, ENT-clinic LFmeá,
S. Hellström Stockholm, Mánsson I, FoU Gothenburg, Engstrand
Lindesberg I, Weitz P, ENT-clinic Vasterás, Kjellen G, ENT-clinic Kalmar,
Carlborg B. ENT-clinic Malmö
The National Quality Register for ENT-healthcare in Sweden has
been in use for 7 years. At present the register for septum sur-
gery stores data from over 4000 patients and almost all Swedish
ENT-clinics are contributing. Of major interest is that the register
records, 6 months after surgery, the patient satisfaction, via a
questionnaire, using a four-grade scale. The patients are grading
their symptoms as ‘completely gone’, ‘almost gone’, ‘no change’
or ‘worse’. ‘Completely gone’ and ‘almost gone’ are categorised
as 'satisfied’. At an ENT- meeting in 2000, the delegates were
engaged in a process identifying factors improving septoplasty
surgery. At that time the register contained 711 patients and
approximately 70% of the patients were satisfied with the out-
come of the operation. However, the delegates assessed this
result unacceptable and considered 90 % ‘satisfied’ patients as an
appropriate standard. No specific factors which could influence
the outcome of the septoplasty procedure were identified at that
time, though a proper information about the operation to the
patient was considered of importance. During the following years
a standardized patient information form has been produced and is
now accepted during a consensus meeting (fall 2004) of Swedish
rhinologists. At the same time a manual for the whole chain of
events, from symptoms, diagnostics to the surgical procedure and
post-operative care was established. We believe that these two
documents will induce a process in which both patients and the
profession will gain a mutual understanding of the pros and cons
regarding septoplasty, and unnecessary surgery minimized.
Through a continuous follow-up by the register the clinics can
follow their own ‘patients satisfaction’ and thus introduce routines
that will improve the results. As an example one of the ENT-
clinics, by use of Register data, increased their patient satisfaction
from initially 60% to 75% during a two-year period. At present
76% of the Swedish patients undergoing septoplasty are satisfied
and the results have thus improved since 5 years ago. It will be
interesting to see which results will be reached in future when the
two documents described have been in use for some time.
Abstract no.: 025
Correspondence between three olfactory tests and supra-
threshold odor intensity ratings
Koskinen S, Department of Food Technology, University of Helsinki,
Vento SI, Jorvi Hospital, Helsinki University Central Hospital, Malmberg
H, Department of Otorhinolaryngology, Helsinki University Central Hos-
pital, Tuorila H, Department of Food Technology, University of Helsinki
The capability of three olfactory tests (European Test of Olfac-
tory Capabilities Sniffin' Sticks and Cross-Cultural Smell Iden-
tification Test) to similarly classify subjects as normosmics,
hyposmics, and anosmics as well as the relation between test per-
formance and suprathreshold ortho- and retronasal odor intensity
ratings were examined.
Forty-eight subjects (aged 15-84, mean 49.5 years) completed
three olfactory tests, rated aqueous solutions of vanilla (0-0.31%)
and lemon aroma (0-0.17%) for odor and flavor intensity. Thirty-
eight had subjectively normal olfaction and ten subjects had case
histories indicating anosmia. The tests were highly correlated
and differentiated anosmic, hyposmic, and normosmic subjects.
Some discrepancy was seen in the olfactory diagnoses given
by the three tests on individual level. In principal component
analysis (PCA), olfactory measurements were loaded on three
components: 1) odor detection, discrimination and identification,
2) suprathreshold intensity ratings and 3) threshold for n-butanol.
Age was associated with a decrease in olfactory test scores. The
tests separated anosmics and normosmics highly significantly, and
permitted an assessment of hyposmia if the limits suggested in this
study are used. The suprathreshold odor intensity ratings reflected
a different dimension of olfaction than the olfactory tests.
Abstract no.: 026
What happens to patients with nasal stuffiness and a
pathological rhinomanometry left without surgery?
Thulesius H. Váxjö Central Hospital. Jessen M, Váxjö Central Hospital
Objective: We wanted to study the natural history of patients with
nasal stuffiness and a pathological rhinomanometry.
It would seem obvious that these patients still suffer nasal stuffi-
ness after several years. However, is it true?
Method: We recalled 27 patients (10 women and 17 men, mean
age 53 years) complaining about nasal stuffiness between 1995-
1997 and with a positive rhinomanometry but left without surgery
for various reasons.
At baseline an ENT investigation including rhinomanometry,
before and after decongestion was performed. All patients
had a pathological high nasal airway resistance (NAR) after
decongestion but did not undergo surgery. Exactly the same
investigation with the same device and staff was performed at
follow-up 8-9 years after baseline.
Results: At follow-up mean NAR (V2) for the narrower side
went down from 46 to 31, and for the wider side from 19 to 16.
Subjective nasal stuffiness was unchanged for 56%, reduced for
33%, and increased for 11% of the patients. These are prelimi-
nary results, and 13 more patients will be examined.
Conclusion: A decrease in mean nasal airway resistance (NAR)
was seen while subjective nasal stuffiness remained unchanged
for a majority of the patients. Reasons for the rhinomanometric
changes will be discussed.
Abstract no.: 027
Screening and rehabilitation of olfaction aftertotal laryngec-
tomy in Swedish patients: Results from an intervention
study using the Nasal Airflow- Inducing Maneuver (NAIM)
Finizia C, MD, PhD Department of Otolaryngology, Risberg Berlin Birgit,
8 Læknablaðið/Fylgirit 51 2005/91