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J Neurol Surg B Skull Base
DOI: 10.1055/a-2599-4262
Original Article

Association between Objective and Subjective Olfactory Dysfunction in SARS-CoV-2-Positive Patients Undergoing Skull Base Surgery

Bastien A. Valencia-Sanchez 
1   Department of Otolaryngology – Head and Neck Surgery, Mayo Clinic Florida, Jacksonville, Florida, United States
,
Prishae Wilson 
1   Department of Otolaryngology – Head and Neck Surgery, Mayo Clinic Florida, Jacksonville, Florida, United States
,
Natasha N. Najmi
1   Department of Otolaryngology – Head and Neck Surgery, Mayo Clinic Florida, Jacksonville, Florida, United States
,
Alaa Alhalabi
1   Department of Otolaryngology – Head and Neck Surgery, Mayo Clinic Florida, Jacksonville, Florida, United States
,
Kaisorn Chaichana
2   Department of Neurological Surgery, Mayo Clinic Florida, Jacksonville, Florida, United States
,
Angela M. Donaldson
1   Department of Otolaryngology – Head and Neck Surgery, Mayo Clinic Florida, Jacksonville, Florida, United States
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Abstract

Objective

This study aimed to investigate the association between objective and subjective olfactory assessments in patients with recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection undergoing endoscopic endonasal skull base surgery (EESBS).

Design

Retrospective cohort study.

Setting

Academic medical center.

Participants

Adult patients with and without recent SARS-CoV-2 infection who underwent EESBS for sellar and parasellar lesion resection between 2020 and 2024 at the Mayo Clinic in Florida, Jacksonville, FL.

Main Outcome Measures

Pre- and postoperative self-reported olfactory dysfunction and University of Pennsylvania Smell Identification Test (UPSIT) scores were collected.

Results

Patients with recent SARS-CoV-2 infection had a similar rate of discrepant preoperative objective olfactory assessments (38.2%, 26/68) compared with SARS-CoV-2-negative patients (39.9%, 127/318). SARS-CoV-2-positive patients were twice as likely to report postoperative subjective olfactory dysfunction (46.2%, 12/26) compared with SARS-CoV-2-negative patients (18.1%, 23/127, p = 0.002). There was no statistically significant difference in the mean preoperative (p = 0.162) or postoperative (p = 0.724) UPSIT scores between both groups.

Conclusion

Patients with recent SARS-CoV-2 infection and discrepant preoperative objective olfactory assessments were twice as likely to self-report olfactory dysfunction following EESBS compared with SARS-CoV-2-negative controls. This increase in self-reported olfactory dysfunction was not accompanied by changes in objective psychophysical testing. These findings suggest that SARS-CoV-2 infection may impact subjective olfactory recovery following EESBS.

Keywords

olfaction - olfactory dysfunction - skull base surgery - SARS-CoV-2 - UPSIT

Previous Presentation

The findings from this study were presented as a podium presentation at the NASBS 34th Annual Meeting and 9th World Congress of the World Federation of Skull Base Societies, held in New Orleans, LA, from February 13–16, 2025.




Publication History

Received: 12 March 2025

Accepted: 29 April 2025

Article published online:
23 May 2025

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