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J Neurol Surg B Skull Base 2021; 82(04): 410-416
DOI: 10.1055/s-0039-3400751
Original Article

Bilateral Smell Preservation is Routinely Possible following Endoscopic Endonasal Approach for Sellar/Suprasellar Lesions

Kuan-Chung Ting‡   *
1   Department of Otolaryngology, Taipei Veterans General Hospital, Taoyuan Branch, Taiwan
2   School of Medicine, National Yang-Ming University, Taipei, Taiwan
,
Wei-Hsin Wang‡   *
3   Department of Neurosurgery, Taipei Veterans General Hospital, Taipei, Taiwan
4   Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
,
Edward C. Kuan
5   Department of Otolaryngology - Head and Neck Surgery, University of California, Irvine, Orange, California, United States
,
Yung-Yang Lin
4   Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
6   Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
,
Ming-Ying Lan 
2   School of Medicine, National Yang-Ming University, Taipei, Taiwan
7   Department of Otorhinolaryngology - Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
› Author Affiliations
Funding This research was supported by grants from the Taipei Veterans General Hospital (V108C-088) to M.Y.L.
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Abstract

Objective The endoscopic endonasal approach (EEA) has been shown to be an effective means to access sellar lesions. However, there are limited studies centered on evaluating olfactory function after surgery. In this study, we assessed the pre- and postoperative olfactory function of patients who underwent EEA for sellar and suprasellar lesions. The impact of nasoseptal flap use on olfaction was further analyzed.

Study Design A retrospective study.

Setting A tertiary-care referral center in Taiwan.

Participants Patients with sellar and suprasellar lesions who underwent EEA and pre- and postoperative olfaction assessment from August 2015 to March 2018 were included in the study.

Main Outcome Measures The patients' olfactory function was examined pre-and postoperatively using the Sniffin' Sticks odor identification test. Data regarding demographics, olfactory scores, pathology, reconstructive technique, graft usage, and extent of resection were retrieved.

Results A total of 106 patients (36 males and 70 females) were enrolled, with a mean age of 51 years. There were 76 pituitary tumors, 12 Rathke's cleft cysts, 7 craniopharyngiomas, 7 meningiomas, and 4 other lesions. The nasoseptal flap was used in 39 patients for skull base reconstruction, and these patients had no statistically significant change between pre- and postoperative olfactory scores (p = 0.283). Moreover, a statistically significant improvement of olfactory scores was found in patients in whom the nasoseptal flap was not used.

Conclusion Olfactory function may be reliably preserved after EEA, with or without nasoseptal flap harvest and use.

Keywords

olfaction - endoscopic endonasal approach - sellar - hyposmia - nasoseptal flap

Authors' Contributions

K.C.T. and W.H.W. contributed to data collection and manuscript preparation. M.Y.L. and Y.Y.L. contributed to project design, expert opinion, and review and approval of the final manuscript. E.C.K. contributed to expert opinion, and review and approval of the final manuscript.


* These authors contributed equally to this article.




Publication History

Received: 12 April 2019

Accepted: 15 October 2019

Article published online:
28 November 2019

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