Olfactory changes after endoscopic endonasal transsphenoidal approach for skull base tumors

Abstract

4.

Hypernasality after using the endoscopic endonasal transsphenoidal approach for skull base tumors

“…However, with the increased number of EETSA procedures, studies concerning the quality of life of patients after EETSA have recently been reported . In our previous studies, olfactory changes increased significantly after EETSA . Of the 413 EETSA patients who underwent EETSA in our clinic, hypernasality was one of the complaints.…”

Periodic olfactory assessment in patients undergoing skull base surgery with preservation of the olfactory strip

“…Rotenberg, Tam, and Kim described a superior incision that only leaves the most superior 1 cm of the septum (i.e., olfactory cleft). This aggressive harvesting sacrifices a significant amount of olfactory epithelium and may account for their reported decline in olfactory scores.…”

Olfaction in Endoscopic Sinus and Skull Base Surgery

“…Of the 19 biopsy specimens that contained olfactory epithelium, 10 had an influx of lymphocytes, macrophages, and eosinophils. Seven of these 10 patients (70%) had an abnormal UPSIT score (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Of the 12 patients with a normosmia (UPSIT score >35), only 3 (25%) had an inflammatory response.…”

“…4,[12][13][14] Addressing olfaction is also important before endoscopic endonasal skull base surgery, because smell loss may occur during tumor resection or harvest of a large nasoseptal flap for reconstruction. [15][16][17][18] In a survey of practicing otolaryngologists, roughly 40% routinely discuss the potential for postoperative anosmia with patients. 11 This figure is important because 17% of malpractice litigation cases from ESS pertain to smell loss or complete anosmia.…”