Postoperative Olfaction after Pituitary Surgery: Comparison of Endoscopic and Microscopic Approaches

Objective: The aim of the study was to evaluate postoperative olfactory disorders after pituitary surgeries, either performed through an endoscopic or microscopic approach. Study Design: Prospective analysis. Methods: In both endoscopic and microscopic approach groups of 25 patients each, olfaction was evaluated with the SmellDiskettes (Sensonics Inc., Haddon Heights, New Jersey, United States) Olfaction Test preoperatively and postoperative 1st and 6th months. In addition, the relation of intraoperative cerebrospinal fluid (CSF) leakage from the pituitary or postoperative synechiae formation with olfaction system was assessed. Results: There were 2 hyposmic and no anosmic patients in the endoscopic group whereas microscopic group had 13 hyposmic and 5 anosmic patients. Differences between groups were statistically significant. In the endoscopic group CSF leakage was observed in 9 patients while microscopic group had 10 CSF leakages. Nevertheless, no statistically significant difference was detected between CSF leakages and olfactory disturbances. However, synechia was observed in nine patients of microscopic group, but only one in endoscopic group. There was statistically significant difference between the presence of synechia and olfactory disturbances. Conclusion: In this first prospective comparative study on the olfactory effects of endoscopic and microscopic approaches in pituitary surgery, our results suggest that endoscopic approach seems to be more advantageous than microscopic approach on protecting olfactory system and function.