Endoscopic approaches to pituitary lesions: Difficulties and challenges

Evaluation of olfactory function in patients undergoing endoscopic skull base surgery with nasoseptal flap

Introduction

Endoscopic transnasal access to the skull base, both for treatment and reconstruction, can cause olfactory morbidity. Knowing the main consequences of this intervention is essential to have objective criteria for decision-making regarding the appropriate surgical technique.

Objectives

The aim of this study is to determine the impact on olfactory function of the endonasal endoscopic access to the skull base with the creation of the nasoseptal flap.

Methods

A prospective research was carried out in which 22 patients who underwent endoscopic transnasal surgery at the skull base, with the creation of a nasoseptal flap. The Connecticut Chemosensory Clinical Research Center test was applied before and at the 1^st, 3^rd and 6^th postoperative months.

Results

The results showed that only in the first month of follow-up the mean patient classification was statistically worse than at the other evaluation moments (p < 0.05), but there was no mean difference in the Connecticut score classification between the other moments (p > 0.05); that is, patients showed worsening in the 1^st month and returned to the preoperative mean after the 3^rd month of follow-up.

Conclusion

The present study showed that the postoperative decrease in olfaction is transient, since the patient's sense of smell returns to pre-surgical values in the 3^rd postoperative month.