Potential conflict of interest: None provided.
Olfactory and sinonasal outcomes in endoscopic transsphenoidal skull-base surgery
Article first published online: 8 OCT 2012
© 2013 ARS-AAOA, LLC
International Forum of Allergy & Rhinology
Volume 3, Issue 3, pages 217–220, March 2013
How to Cite
How to Cite this Article: Olfactory and sinonasal outcomes in endoscopic transsphenoidal skull-base surgery. Int Forum Allergy Rhinol, 2013; 3:217–220., , ,
Presented orally at the Combined Otolaryngology Spring Meeting in April 2012, San Diego, CA.
- Issue published online: 12 MAR 2013
- Article first published online: 8 OCT 2012
- Manuscript Accepted: 7 AUG 2012
- Manuscript Revised: 2 AUG 2012
- Manuscript Received: 12 MAR 2012
- nasal function;
- skull base;
- pituitary surgery;
- endoscopic surgery
Endoscopic anterior skull-base surgery has been previously suggested to cause a significant deterioration in olfactory function. Given the impact on quality of life, the objective of this study was to determine the effect of a unilateral middle-turbinate–sacrificing approach on olfactory function and sinonasal outcome.
Prospective cohort study comparing olfactory and sinonasal outcomes pre- and post-transsphenoidal skull-base surgery. Olfaction was the primary outcome and was measured prospectively using the University of Pennsylvania Smell Identification Test (SIT). Sinonasal symptoms were assessed subjectively via sinonasal-specific questions from the 22-item Sino-Nasal Outcome Test (SNOT-22), and objectively via the Lund-Kennedy Endoscopic Scoring system (LKES).
Twenty-two patients met study inclusion criteria and completed all data acquisition. The mean preoperative SIT score was 34.8 and the mean postoperative SIT value was 35.1 (p = 0.37). The average change in score (delta) was an increase of 0.3, with changes ranging from −3 to +4. When examined categorically, 91% of patients maintained their preoperative olfactory function classification. There was no significant difference in mean pre- and postoperative symptom scores. A small increase in the LKES was noted, from a mean of 0.6 to 2.5 (p = 0.001) in the early postoperative period.
Olfactory function, as measured by the SIT test, was preserved with a middle-turbinate–sacrificing skull-base approach. Subjective sinonasal symptom scores were unaffected, but a slight worsening of objective endoscopic appearance was noted.