Olfactory Function Following Endoscopic Endonasal Skull Base Surgery: Clinical and Histological Outcomes
Olfactory Function Following Endoscopic Endonasal Skull Base Surgery: Clinical and Histological Outcomes
The purpose of this study is to compare a subject's sense of smell before and after endoscopic endonasal surgery to remove a skull base abnormality (i.e. tumor, inflammatory process, fracture, defect, etc.) and use the information collected to validate approaches to surgery that will minimize side effects to the sense of smell function. Data will be collected using a smell identification test along with two questionnaires. In addition, demographic, medical history, treatment, outcome, and follow-up information will be collected.
Preoperatively, every patient will undergo an olfactory evaluation using the University of Pennsylvania Smell IdentificationTest (UPSIT), comprising 40 "scratch and sniff" odorants. This test has been validated by age and gender. The test was re-administered at 6 weeks, 3 months, and 6 months following surgery (time window of 62 weeks). Timing of follow-up visits is based on previously published works suggesting that mucosal regeneration is complete in approximately 6 weeks, but return of ciliary function takes about 3 months.17 Furthermore, the reported persistence of nasal crusting up to 100 days after surgery warrants a 6-month (minimum)visit to assess possible delayed recovery of olfaction.
Pertinent data will be collected, including patient demographics, relevant medical/surgical history, and nasal symptoms. Operative data regarding the surgical approach and the type of reconstructive flaps were also recorded. Postoperative course in reference to epistaxis, CSF leak, or need for revision surgery was also documented. To better define the cohort,patients will be categorized into two groups: group I, patients who underwent a nasoseptal flap reconstruction; and group II,patients who underwent rescue flap technique.
Nonparametric data will be analyzed using the Wilcoxon signed rank test and the Mann-Whitney test to allow the intra and intergroup comparison of preoperative and postoperative scores. All statistical analysis will be performed using SPSS v20(IBM, Armonk, NY). All probability values were two-tailed, andP < .05 is considered statistically significant.
Inclusion Criteria:
Exclusion Criteria: