Analysis of Olfaction after Bilateral Nasoseptal Rescue Flap Transsphenoidal Approach with Olfactory Mucosal Preservation.
Publication Title
Otolaryngology and head and neck surgery
Document Type
Article
Publication Date
11-1-2019
Keywords
Adolescent; Adult; Aged; Aged, 80 and over; Endoscopy; Female; Humans; Incidence; Male; Middle Aged; Nasal Mucosa; Nasal Septum; Olfaction Disorders; Pituitary Neoplasms; Postoperative Complications; Reconstructive Surgical Procedures; Retrospective Studies; Smell; Sphenoid Sinus; Surgical Flaps; Young Adult
Abstract
OBJECTIVE: To ascertain the impact of septal olfactory strip preservation and bilateral rescue flap elevation on the incidence of olfactory dysfunction.
STUDY DESIGN: Case series with chart review of patients undergoing endoscopic endonasal skull base surgery (2012-2014).
SETTING: Providence Saint John's Health Center and John Wayne Cancer Institute.
SUBJECTS AND METHODS: The incidences of postoperative epistaxis, hyposmia, and anosmia were analyzed using the Brief Smell Identification Test (B-SIT), which was completed in 110 of the 165 patients.
RESULTS: Seventy-eight patients required extended approaches. Bilateral nasoseptal rescue flaps were elevated in 144 patients (87.3%) and pedicled nasoseptal or middle turbinate flaps in 21 patients (12.7%). The neurovascular pedicles were preserved in all patients, and there were no episodes of postoperative arterial epistaxis. Normal olfaction was noted in 95 patients (86%), with new hyposmia noted in 5 patients (5.5%). Within the rescue flap cohort, new hyposmia occurred in 6.3% (
CONCLUSIONS: Superior olfactory strip preservation during elevation of reconstructive flaps preserves olfactory function and maintains adequate surgical exposure. In addition, rescue flaps have significantly diminished the rate of arterial postoperative epistaxis while maintaining the ability to harvest nasoseptal flaps for future reconstruction.
Area of Special Interest
Neurosciences (Brain & Spine)
Specialty/Research Institute
Neurosciences
Specialty/Research Institute
Otolaryngology
Specialty/Research Institute
Surgery
