Intranasal Volume Changes Caused by the Endoscopic Endonasal Transsphenoidal Approach and Their Effects on Nasal Functions

Kim, Do Hyun; Hong, Yong-Kil; Jeun, Sin‐Soo; Park, Yong Jin; Kim, Soo Whan; Cho, Jin Hee; Kim, Boo Young; Han, Sun Wook; Lee, Yong Joo; Hwang, Jae Hyung; Kim, Sung Won

doi:10.1371/journal.pone.0151531

Cited by 12 publications

(12 citation statements)

References 24 publications

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“…Of the studies reporting CCSIT outcomes, two studies did not report adequate summary statics for meta‐analysis. These two excluded studies were both from Kim et al, and showed that ESBS was associated with significant changes in nasal cavity dimensions, but these anatomic changes did not correlate with changes in olfaction . In addition, multiple studies showed overlapping cohorts from the same study group, and thus three additional studies were excluded.…”

Section: Resultsmentioning

confidence: 99%

“…These two excluded studies were both from Kim et al, and showed that ESBS was associated with significant changes in nasal cavity dimensions, but these anatomic changes did not correlate with changes in olfaction. 44,45 In addition, multiple studies showed overlapping cohorts from the same study group, and thus three additional studies were excluded. Only the studies with the most comprehensive cohort were included in the meta-analysis.…”

Section: Quantitative Analysis/meta-analysismentioning

confidence: 99%

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Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta‐analysis

et al. 2019

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Objectives Determine the effect of endoscopic skull base surgery (ESBS) on long‐term olfactory outcomes after surgery. Methods An English‐language search was conducted using the Cochrane, MEDLINE, Scopus, and Embase databases from January 2000 to October 2017 for adult patients undergoing ESBS with subjective and objective olfaction outcomes. Two authors independently examined articles to identify those meeting inclusion criteria. Studies examining objective olfactory outcomes after ESBS were included in the meta‐analysis. A random‐effects meta‐analysis of patients undergoing sellar and parasellar ESBS was conducted to compare preoperative and postoperative olfactory outcomes using the University of Pennsylvania Smell Identification Test (UPSIT) and Cross‐Cultural Smell Identification Test (CCSIT). Results Among 339 eligible articles, 29 articles met inclusion criteria. Twenty‐five of these focused on sellar and parasellar tumors. Individual articles not meeting criteria for meta‐analysis were qualitatively reported. Meta‐analysis showed there was no difference in preoperative and postoperative olfactory function after sellar and parasellar ESBS based on the UPSIT (five studies, mean difference [MD] = −1.03; 95% CI: −3.98, 1.93; P = .50) and the CCIST (three studies, MD = −0.77; 95% CI: −3.03, 1.49; P = .50). A pooled overall meta‐analysis revealed similar results (eight studies, effect size = −0.30; 95% CI: −0.79, 0.18; P = .22). However, heterogeneity for all meta‐analyses was high (I2 > 95%, P < .01), suggesting significant variation in the included studies. Conclusions Based on published objective olfaction outcomes after sellar and parasellar ESBS, there was no significant difference between preoperative and postoperative olfaction. Further prospective studies using validated objective measures of olfaction are required to improve our understanding on this subject. Level of Evidence 2a Laryngoscope, 129:1998–2007, 2019

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Section: Resultsmentioning

confidence: 99%

Section: Quantitative Analysis/meta-analysismentioning

confidence: 99%

Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta‐analysis

et al. 2019

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“…In addition, there are some limitations involving this technique related to surgical instrumentations and limited work space [35, 36, 37]. The workspace boundary could be described along with the surgical approach in addition to the volume constraint [37,40,41]. Satisfactory information about the workspace characteristics makes it a practical new modality for robotic workspace classification.…”

Section: Discussionmentioning

confidence: 99%

Anatomical workspace study of Endonasal Endoscopic Transsphenoidal Approach

et al. 2019

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AbstractPurposeTo determine the workspace through an anatomical dimensional study of the skull base to further facilitate the design of the robot for endonasal endoscopic transsphenoidal (EET) surgery.MethodsThere were 120 cases having a paranasal sinus CT scan in the database. The internal volumes of the nasal cavities (NC), the volumes of the sphenoid sinuses (SS), and the distance between the anterior nasal spine and base of the sellar (d-ANS-BS) were measured.ResultsThe Pearson correlation coefficient (PCC) between the relevant distances and the volumes of the right NC was 0.32; between the relevant distances and the volumes of the left NC was 0.43; and between the relevant distances and volumes of NC was 0.41; with a statistically significant difference (p < 0.001). All PCCs had a statistically significant meaningful difference (p < 0.05).ConclusionThe volume of NCs were significantly correlated with distances (p < 0.05). The safest and shortest distance to guide the robotic arm length in the EET approach could be represented by d-ANS-BS. This result was also used as primary information for further robotic design.

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“…With regard to the sample‐size calculation, Kim et al 17,18 have reported that ILST‐induced intranasal volume changes do not correlate with objective olfactory changes after binostril EETS, suggesting that the overall impact of ILST on olfaction is minimal. In an earlier study of endoscopic sinus surgery (ESS), the incidence of objective olfactory decline after PRST was 12% in patients with chronic rhinosinusitis 19 .…”

Section: Methodsmentioning

confidence: 99%

Superior turbinate management and olfactory outcome after endoscopic endonasal transsphenoidal surgery for pituitary adenoma: a propensity score‒matched cohort study

Luo

Zhang

et al. 2020

Int Forum Allergy Rhinol

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Background Surgical management of the superior turbinate ST is required to access the sella in endoscopic endonasal transsphenoidal surgery EETS for pituitary adenoma Two common ST management techniques include partial resection of the ST PRST and intentional lateralization of the ST ILST Given the concentrated distribution of the olfactory nerve fibers on the medial surface of the ST in this study we aimed to ascertain whether PRST worsens the objective olfactory outcome when compared with ILST Methods A retrospective propensity score-matched cohort study was performed at a tertiary referral center A total of adult patients undergoing EETS for pituitary adenoma were analyzed The threshold test STT and the-item identification test SIT-from "Sniffin' Sticks" were administered for separate nostrils preoperatively and months postoperatively Results Of patients had right-sided PRST and received right-sided ILST Propensity score matchingcontrolling for olfactory-related confounding factors including gender age medical comorbidities surgical technique and preoperative olfaction-resulted in matched pairs When comparing the-month postoperative olfactory performance of the right nostril the STT score was significantly lower in the PRST group than the ILST group p = η for effect size estimate = but the SIT-scores were similar in the groups p = Overall the olfactory outcomes for the right nostril did not qualitatively differ between the PRST and ILST groups p = Conclusion Despite its association with threshold impairment PRST in EETS does not seem to carry an additional risk of postoperative olfactory dysfunction

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Intranasal Volume Changes Caused by the Endoscopic Endonasal Transsphenoidal Approach and Their Effects on Nasal Functions

Cited by 12 publications

References 24 publications

Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta‐analysis

Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta‐analysis

Anatomical workspace study of Endonasal Endoscopic Transsphenoidal Approach

Superior turbinate management and olfactory outcome after endoscopic endonasal transsphenoidal surgery for pituitary adenoma: a propensity score‒matched cohort study

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