Long-term olfactory function outcomes after pituitary surgery by endoscopic endonasal transsphenoidal approach

被引：16

作者：

Kuwata, Fumihiko ^{[1
]}

Kikuchi, Masahiro ^{[1
]}

Ishikawa, Masaaki ^{[2
]}

Tanji, Masahiro ^{[3
]}

Sakamoto, Tatsunori ^{[4
]}

Yamashita, Masaru ^{[5
]}

Matsunaga, Mami ^{[1
]}

Omori, Koichi ^{[1
]}

Nakagawa, Takayuki ^{[1
]}

机构：

[1] Kyoto Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Sakyo Ku, 54 Shogoin Kawahara Cho, Kyoto 6068507, Japan

[2] Hyogo Prefectual Amagasaki Gen Med Ctr, Dept Otolaryngol Head & Neck Surg, 2-17-77 Higashi Naniwa Cho, Amagasaki, Hyogo 6608550, Japan

[3] Kyoto Univ Hosp, Dept Neurosurg, Sakyo Ku, 54 Shogoin Kawahara Cho, Kyoto 6068507, Japan

[4] Kitano Hosp, Dept Otolaryngol Head & Neck Surg, Kita Ku, 2-4-20 Ogimachi, Osaka 5308480, Japan

[5] Shizuoka Prefectural Gen Hosp, Dept Otolaryngol Head & Neck Surg, Aoi Ku, 4-27-1 Kita Ando, Shizuoka 4208527, Japan

来源：

AURIS NASUS LARYNX | 2020年 / 47卷 / 02期

基金：

日本学术振兴会;

关键词：

Endoscopic endonasal transsphenoidal approach; Pituitary adenoma; Olfactory function; T&T olfactometer; SKULL-BASE SURGERY; QUALITY-OF-LIFE; SEPTAL FLAP RECONSTRUCTION; NASOSEPTAL RESCUE FLAPS; PRESERVATION; SYMPTOMS; IMPACT; TUMORS;

D O I：

10.1016/j.anl.2019.07.002

中图分类号：

R76 [耳鼻咽喉科学];

学科分类号：

100213 ;

摘要：

Objectives: To evaluate long-term olfactory outcomes in patients who underwent pituitary surgery through the endoscopic endonasal transsphenoidal approach (EETSA) by T&T olfactometer. Methods: We retrospectively reviewed 26 patients who underwent pituitary surgery via EETSA. Olfactory function was assessed by T&T olfactometer before and 6 months after surgery. The mean of recognition thresholds for five different odorants was used. The change in the mean recognition threshold values was evaluated in the entire cohort and the subgroup analysis was performed according to the age, sex, past history of pituitary surgery (primary surgery or revision surgery), histopathology (non-functioning adenoma (NFA) or functioning adenoma (FA)), reconstruction procedure (rescue flap or nasoseptal flap), and superior turbinate management (preserved or resected). Results: Of the 26 patients (12 men and 14 women, median age 53 years), 21 patients were newly diagnosed with pituitary gland tumor (16 NFAs, 5 FAs) and the remaining 5 were diagnosed with recurrent pituitary gland tumor (4 NFAs and 1 FA). In the whole cohort, the mean recognition threshold values of T&T olfactometer significantly improved after surgery (P = 0.01). Thirteen out of 26 patients (50%) showed olfactory improvement, whereas only 3 (12%) showed deterioration. In the subgroup analysis, olfactory function outcomes were not significantly different between the subgroups with respect to the age, sex, past history of pituitary surgery, histopathology, reconstruction procedure, or superior turbinate management. The olfactory function tended to worsen in the revision surgery group compared to that in the primary surgery group, but not significantly (P = 0.06). Conclusions: The olfactory function was improved or maintained after pituitary surgery via EETSA in 88% of patients, indicating the benefits of low invasiveness of our surgical treatment. On the other hand, three patients (12%) demonstrated deterioration of olfactory function, suggesting that the risk of postoperative olfactory dysfunction should be informed to patients. (C) 2019 Elsevier B.V. All rights reserved.

引用

页码：227 / 232

页数：6

共 23 条

[1] Expanded endonasal approach using vascularized septal flap reconstruction for skull base tumors has a negative impact on sinonasal symptoms and quality of life [J].