Olfactory outcomes following endoscopic pituitary surgery with or without septal flap reconstruction: a randomized controlled trial

Tam, Samantha; Duggal, Neil; Rotenberg, Brian

doi:10.1002/alr.21069

Cited by 72 publications

(96 citation statements)

References 13 publications

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“…Of the studies focusing on objective olfactory outcomes after ESBS in the sella/parasella (Table ), only three found differences in postoperative olfaction after ESBS . Reasons for the discrepancy observed in those three studies could be differences in technique or biases in pre‐ and postoperative patient counseling, the latter of which may affect patient self‐confidence when taking the olfaction test.…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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

et al. 2019

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“…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 .…”

Section: Introductionmentioning

confidence: 88%

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

Kim¹,

Shin²,

Kim

et al. 2015

The Laryngoscope

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“…However, the flap described by Tam et al has little respect for the olfactory strip on the septum. 8 In contrast, the technique described in this study utilizes the nasal floor for width. Such mucosa is thick and makes for good reconstruction.…”

Section: Discussionmentioning

confidence: 97%

“…3,8,9 Unfortunately, standardization of surgical technique does not exist and what is described surgically in some series is not the same as others. In particular, the degree of tissue resection and the location of the nasoseptal flap differ greatly between centers with fellowship-trained rhinologists and those without.…”

Section: Introductionmentioning

confidence: 99%

The Olfactory Strip and Its Preservation in Endoscopic Pituitary Surgery Maintains Smell and Sinonasal Function

et al. 2015

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).Differing outcomes on olfaction have been reported from transsphenoidal approaches. [1][2][3][4] In general, patients prefer the endoscopic approach, 5 and olfactory scores are better after the endoscopic route. 6 The nasoseptal flap, in particular, to reconstruct the skull base as part of the overall process has been implicated in smell dysfunction. However, much of the literature on the impact of the nasoseptal flap comes from extended skull base surgery. In our institution, utilizing a small modified nasoseptal flap during simple pituitary surgery has greatly improved our reconstructive options and access. However, controversy exists as to the additional morbidity of utilizing such an approach. The existing studies on patients with large skull base tumors are not an appropriate population to discuss the impact of surgery or

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Olfactory outcomes following endoscopic pituitary surgery with or without septal flap reconstruction: a randomized controlled trial

Abstract: Endoscopic pituitary surgery results in decreased olfaction with or without deploying a septal flap. However, use of the HB flap for reconstruction can worsen hyposmia at least 6 months after surgery. Olfaction should be considered when use of the HB flap is planned.

Cited by 72 publications

References 13 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

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

The Olfactory Strip and Its Preservation in Endoscopic Pituitary Surgery Maintains Smell and Sinonasal Function

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