Impact of posterior septectomy on olfaction in endoscopic endonasal transsphenoidal surgery.

PLoS One

Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Published: January 2025


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Article Abstract

Background: Endoscopic endonasal transsphenoidal surgery is widely used to resect pituitary adenomas, yet its impact on olfactory function after resection of the posterosuperior nasal septum remains a concern. To optimize surgical techniques to preserve olfactory function, it is essential to understand the relationship between the extent of septal resection and olfactory outcomes.

Methods: This retrospective study analyzed 295 patients who underwent pituitary adenoma surgery. The extent of nasal septum resection was quantified and its impact on olfactory function was assessed using the Cross-Cultural Smell Identification Test (CCSIT), Sino-Nasal Outcome Test-22 (SNOT-22), and a Visual Analog Scale (VAS) for olfactory loss. Preoperative and 6-month postoperative scores were compared to evaluate changes in olfactory function.

Results: There was a significant correlation between larger septal resections and greater reductions in CCSIT scores, indicating a decline in olfactory function. Furthermore, patients with more extensive septal resections reported increased discomfort and olfactory loss, as evidenced by higher SNOT-22 and VAS scores. These findings highlight the importance of the nasal septum in maintaining laminar airflow and its role in olfactory function.

Conclusion: Study underscores the adverse effects of extensive posterior septectomy on olfactory outcomes. Minimizing the extent of septal resection may help preserve olfactory function, suggesting a need for surgical strategies that maintain septum integrity to reduce the risk of postoperative olfactory impairment.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694954PMC
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0316263PLOS

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