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KMID : 1037420170120020025
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Journal of Korean Skull Base Society
2017 Volume.12 No. 2 p.25 ~ p.32
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The short-term recovery patterns of olfactory function after trans-sphenoidal approach with nasoseptal flap elevation
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Kim Ji-Ryong
Kim El
Jeong Jong-In
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Abstract
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Background: The cases of endoscopic skull base surgery applied in more aggressive lesions have increased recently, raising interests about nasoseptal flap (NSF) for reconstruction. However, transient or permanent olfactory dysfunction may occur after NSF elevation, it have great influence on the quality of life of the patient. The aim of this study was to identify proper intervention time by comparing the recovery patterns of olfactory function after NSF elevation with conventional trans-septal approach.
Methods: All subject were administered self-reporting olfaction score (Visual Analogue Scale [VAS], 0-10) and the threshold, discrimination, and identification (TDI) score of Korean Version of Sniffin Stick Test II (KVSS II) preoperatively. The trans-sphenoidal approach (TSA) was performed with conventional trans-septal approach or NSF elevation. VAS and TDI were followed-up by 12weeks after surgery.
Results: Fifteen patients who underwent TSA were enrolled. Baseline VAS and TDI score were 9.2 and 28.3 in TSA group, and 7.7 and 24.6 in NSF elevation group. VAS of trans-septal approach group was recovered to the preoperative level from 8weeks after surgery, whereas NSF elevation group was 12weeks. TDI scores of trans-septal approach group were 12.1, 25.4, and 24.8 at 4, 8, and 12 weeks after surgery, whereas NSF elevation group were 10.6, 19.7, and 22.1.
Conclusions: After TSA with NSF elevation, olfactory function is more gradually recovered than conventional trans-septal approach, and the intervention about permanent olfactory dysfunction may need to be considered for the poorly-improved olfactory dysfunction until 8weeks after surgery.
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KEYWORD
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Pituitary tumor, Skull base neoplasm, Anosmia
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