Self-Reported Olfactory Outcomes in Transplanum and Transtuberculum Approaches

 

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Abstract

Objectives The aim of this study was to determine the clinical characteristics and cephalometric risk factors associated with decreased postoperative olfaction in patients in whom the transplanum and transtuberculum expanded endonasal approach (EEA) was performed.

Methods A retrospective cohort of 41 patients treated with the transplanum and transtuberculum EEA was divided into two groups based on the maximum change in the postoperative 22-item Sino-Nasal Outcome Test (SNOT22) olfaction score: prolonged olfactory loss group (n = 5) with a ΔSNOT22 olfaction score of ≥ 4 without a return to baseline and a preserved olfaction group (n = 36) with a ΔSNOT22 olfaction score ≤ 3 with return to baseline on follow-up of at least 3 months. Demographics, operative details, and cephalometric measurements were compared between the two groups.

Results There were no differences in terms of the type of surgical approach (transplanum and transtuberculum), resection of turbinates (middle and superior), use of reconstructive flap (nasoseptal flap and reverse flap), or tumor pathology between the two groups. In the prolonged olfactory loss group, there was a smaller angle between the planum and the face of the sella (89.75 ± 9.18 vs. 107.17 ± 16.57 degrees, p = 0.05) and a smaller angle between the anterior nasal spine and the sphenoid sinus face (21.20 ± 2.49 vs. 25.89 ± 4.90 degrees, p = 0.047) compared with the preserved olfaction group.

Conclusions Patients with a narrow angle between the planum and the face of the sella or that between the anterior nasal spine and the sphenoid sinus face are at a higher risk of prolonged olfactory dysfunction with the transplanum and transtuberculum approaches.

Level of Evidence IV.

Author's Contributions

Z.B. and H.D. contributed to data collection and manuscript preparation and editing. A.K. were responsible for data collection and manuscript editing. P.G., G.Z., C.H.S., and K.T. contributed to manuscript editing and review. E.W.W. contributed to the project design and manuscript editing and review.

Publication History

Received: 07 April 2023

Accepted: 17 August 2023

Accepted Manuscript online:
22 August 2023

Article published online:
25 September 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

• References

• 1 Bander ED, Singh H, Ogilvie CB. et al. Endoscopic endonasal versus transcranial approach to tuberculum sellae and planum sphenoidale meningiomas in a similar cohort of patients. J Neurosurg 2018; 128 (01) 40-48
  CrossrefPubMedGoogle Scholar
• 2 Carvalho ACM, Dolci RLL, Rickli JCK. et al. Evaluation of olfactory function in patients undergoing endoscopic skull base surgery with nasoseptal flap. Rev Bras Otorrinolaringol (Engl Ed) 2022; 88 (01) 15-21
  PubMedGoogle Scholar
• 3 Dolci RLL, de Carvalho ACM, Rickli JCK. et al. Relationship between the bilateral removal of the middle nasal turbinate and the olfactory function in endoscopic skull base surgery. World Neurosurg 2020; 142: e337-e343
  CrossrefPubMedGoogle Scholar
• 4 Escada P. Localização e distribuição da mucosa olfactiva humana nas fossas nasais [Localization and distribution of human olfactory mucosa in the nasal cavities]. Acta Med Port 2013; 26 (03) 200-207
  PubMedGoogle Scholar
• 5 Thompson CF, Kern RC, Conley DB. Olfaction in endoscopic sinus and skull base surgery. Otolaryngol Clin North Am 2015; 48 (05) 795-804
  CrossrefPubMedGoogle Scholar
• 6 Patel ZM, DelGaudio JM. Olfaction following endoscopic skull base surgery. Curr Opin Otolaryngol Head Neck Surg 2016; 24 (01) 70-74
  CrossrefPubMedGoogle Scholar
• 7 Lee JJ, Thompson ZS, Piccirillo JF. et al. Risk factors for patient-reported olfactory dysfunction after endoscopic transsphenoidal hypophysectomy. JAMA Otolaryngol Head Neck Surg 2020; 146 (07) 621-629
  CrossrefPubMedGoogle Scholar
• 8 Riva G, Zenga F, Motatto GM. et al. Quality of life after endoscopic skull base surgery: validation and reliability of the Italian version of the Sino-Nasal Outcome Test for Neurosurgery (SNOT-NC). World Neurosurg 2022; 163: e426-e434
  CrossrefPubMedGoogle Scholar
• 9 Rioja E, Bernal-Sprekelsen M, Enriquez K. et al. Long-term outcomes of endoscopic endonasal approach for skull base surgery: a prospective study. Eur Arch Otorhinolaryngol 2016; 273 (07) 1809-1817
  CrossrefPubMedGoogle Scholar
• 10 Park HR, Kshettry VR, Farrell CJ. et al. Clinical outcome after extended endoscopic endonasal resection of craniopharyngiomas: two-institution experience. World Neurosurg 2017; 103: 465-474
  CrossrefPubMedGoogle Scholar
• 11 Upadhyay S, Buohliqah L, Dolci RLL, Otto BA, Prevedello DM, Carrau RL. Periodic olfactory assessment in patients undergoing skull base surgery with preservation of the olfactory strip. Laryngoscope 2017; 127 (09) 1970-1975
  CrossrefPubMedGoogle Scholar
• 12 Friedman M, Caldarelli DD, Venkatesan TK, Pandit R, Lee Y. Endoscopic sinus surgery with partial middle turbinate resection: effects on olfaction. Laryngoscope 1996; 106 (08) 977-981
  CrossrefPubMedGoogle Scholar
• 13 Gong SW, Ahmadi S, Blackburn SL. et al. Sniffin' sticks to measure olfactory function and recovery following bilateral superior turbinate resection as part of endoscopic transsphenoidal approach. Ann Otol Rhinol Laryngol 2021; 130 (06) 636-642
  CrossrefPubMedGoogle Scholar
• 14 DeConde AS, Mace JC, Alt JA, Schlosser RJ, Smith TL, Soler ZM. Comparative effectiveness of medical and surgical therapy on olfaction in chronic rhinosinusitis: a prospective, multi-institutional study. Int Forum Allergy Rhinol 2014; 4 (09) 725-733
  CrossrefPubMedGoogle Scholar
• 15 Zimmer LA, Shah O, Theodosopoulos PV. Short-term quality-of-life changes after endoscopic pituitary surgery rated with SNOT-22. J Neurol Surg B Skull Base 2014; 75 (04) 288-292
  Article in Thieme ConnectPubMedGoogle Scholar
• 16 Mozzanica F, Preti A, Gera R. et al. Cross-cultural adaptation and validation of the SNOT-22 into Italian. Eur Arch Otorhinolaryngol 2017; 274 (02) 887-895
  CrossrefPubMedGoogle Scholar
• 17 Lachanas VA, Tsea M, Tsiouvaka S, Hajiioannou JK, Skoulakis CE, Bizakis JG. The Sino-Nasal Outcome Test (SNOT)-22: validation for Greek patients. Eur Arch Otorhinolaryngol 2014; 271 (10) 2723-2728
  CrossrefPubMedGoogle Scholar
• 18 Kosugi EM, Chen VG, Fonseca VM, Cursino MM, Mendes Neto JA, Gregório LC. Translation, cross-cultural adaptation and validation of SinoNasal Outcome Test (SNOT): 22 to Brazilian Portuguese. Rev Bras Otorrinolaringol (Engl Ed) 2011; 77 (05) 663-669
  PubMedGoogle Scholar
• 19 Rudmik L, Hopkins C, Peters A, Smith TL, Schlosser RJ, Soler ZM. Patient-reported outcome measures for adult chronic rhinosinusitis: a systematic review and quality assessment. J Allergy Clin Immunol 2015; 136 (06) 1532-1540.e2
  CrossrefPubMedGoogle Scholar
• 20 Ogihara H, Kobayashi M, Nishida K, Kitano M, Takeuchi K. Applicability of the cross-culturally modified University of Pennsylvania Smell Identification Test in a Japanese population. Am J Rhinol Allergy 2011; 25 (06) 404-410
  CrossrefPubMedGoogle Scholar
• 21 Altundag A, Tekeli H, Salihoglu M. et al. Cross-culturally modified University of Pennsylvania Smell Identification Test for a Turkish population. Am J Rhinol Allergy 2015; 29 (05) e138-e141
  CrossrefPubMedGoogle Scholar