Sinonasal and Olfactory Quality of Life in Endoscopic Pituitary Surgery and Time Interval to Olfactory Recovery: A Comparative Prospective Study.

BACKGROUND AND

OBJECTIVE

Superior turbinate manipulation is often required in cases of narrow cavities and expanded endonasal approaches with concern for olfaction. The objective of the study was to compare the pre- and postoperative olfactory function in patients undergoing endoscopic endonasal transsphenoidal pituitary excision with and without superior turbinectomy, using the Pocket Smell Identification Test and the quality of life (QOL) and Sinonasal Outcome Test-22 (SNOT-22) scores, irrespective of the extension (Knosp grading) of pituitary tumors. We also aimed to identify olfactory neurons in the excised superior turbinate with immunohistochemical (IHC) stains and correlate them with clinical findings.

MATERIALS AND

METHODS

The study was a prospective, randomized study performed in a tertiary center. Two groups A and B, with superior turbinate preserved and resected, respectively, during endoscopic pituitary resection, were compared using pre- and postoperative Pocket Smell Identification Test and QOL and SNOT-22 scores. The superior turbinate was subjected to IHC staining to identify the presence of olfactory neurons in patients with tumors of pituitary gland requiring endoscopic trans-sphenoid resection.

RESULTS

Fifty patients with sellar tumors were enrolled. The mean age of patients in this study was 46.15 years. The minimum age was 18 years and the maximum was 75 years. Of the 50 patients in the study, 18 were female and 32 were male. Eleven patients had more than one presenting complaint. Loss of vision was the commonest and altered sensorium was the rarest symptom.

CONCLUSION

Superior turbinectomy is a viable option to gain wider access to sella without affecting the sinonasal function, quality of life, and olfaction. There was doubtful presence of olfactory neurons in superior turbinate. The extent of tumor resection and postoperative complications were unaffected and statistically nonsignificant in both the groups.