The Olfactory Strip and Its Preservation in Endoscopic Pituitary Surgery Maintains Smell and Sinonasal Function

Richard J. Harvey, Mark Winder, Andrew Davidson, Tim Steel, Sunny Nalavenkata, Nadine Mrad, Ali Bokhari, Henry Barham, Anna Knisely

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background The return of olfaction and of sinonasal function are important end points after pituitary surgery. Opinions differ on the impact of surgery because techniques vary greatly. A modified preservation of the so-called olfactory strip is described that utilizes a small nasoseptal flap and wide exposure. Methods A cohort of patients undergoing pituitary surgery and endoscopic sinonasal tumor surgery were assessed. Patient-reported outcomes (Sino-Nasal Outcome Test [SNOT22] and Nasal Symptom Score [NSS]) were recorded. A global score of sinonasal function and the impact on smell and taste were obtained. Objective smell discrimination testing was performed in the pituitary group with the Smell Identification Test. Outcomes were assessed at baseline and at 6 months. Results Ninety-eight patients, n = 40 pituitary (50.95 ± 15.31 years; 47.5% female) and n = 58 tumor (52.35 ± 18.51 years; 52.5% female) were assessed. For pituitary patients, NSSs were not significantly different pre- and postsurgery (2.75 ± 3.40 versus 3.05 ± 3.03; p = 0.53). SNOT22 scores improved postsurgery (1.02 ± 0.80 versus 0.83 ± 0.70; p = 0.046). Objective smell discrimination scores between baseline and 6 months were similar (31.63 ± 3.49 versus 31.35 ± 4.61; p = 0.68). No difference in change of olfaction was seen compared with controls (Kendall tau-b p = 0.46). Conclusions Preservation of the olfactory strip can provide a low morbidity approach without adversely affecting olfaction and maintaining reconstruction options.

LanguageEnglish
Pages464-470
Number of pages7
JournalJournal of Neurological Surgery, Part B: Skull Base
Volume76
Issue number6
DOIs
Publication statusPublished - 15 Jun 2015

Fingerprint

Smell
Nose
Neoplasms
Morbidity

Cite this

Harvey, Richard J. ; Winder, Mark ; Davidson, Andrew ; Steel, Tim ; Nalavenkata, Sunny ; Mrad, Nadine ; Bokhari, Ali ; Barham, Henry ; Knisely, Anna. / The Olfactory Strip and Its Preservation in Endoscopic Pituitary Surgery Maintains Smell and Sinonasal Function. In: Journal of Neurological Surgery, Part B: Skull Base. 2015 ; Vol. 76, No. 6. pp. 464-470.
@article{a3a1654092f84c8b8af2efaadc357a09,
title = "The Olfactory Strip and Its Preservation in Endoscopic Pituitary Surgery Maintains Smell and Sinonasal Function",
abstract = "Background The return of olfaction and of sinonasal function are important end points after pituitary surgery. Opinions differ on the impact of surgery because techniques vary greatly. A modified preservation of the so-called olfactory strip is described that utilizes a small nasoseptal flap and wide exposure. Methods A cohort of patients undergoing pituitary surgery and endoscopic sinonasal tumor surgery were assessed. Patient-reported outcomes (Sino-Nasal Outcome Test [SNOT22] and Nasal Symptom Score [NSS]) were recorded. A global score of sinonasal function and the impact on smell and taste were obtained. Objective smell discrimination testing was performed in the pituitary group with the Smell Identification Test. Outcomes were assessed at baseline and at 6 months. Results Ninety-eight patients, n = 40 pituitary (50.95 ± 15.31 years; 47.5{\%} female) and n = 58 tumor (52.35 ± 18.51 years; 52.5{\%} female) were assessed. For pituitary patients, NSSs were not significantly different pre- and postsurgery (2.75 ± 3.40 versus 3.05 ± 3.03; p = 0.53). SNOT22 scores improved postsurgery (1.02 ± 0.80 versus 0.83 ± 0.70; p = 0.046). Objective smell discrimination scores between baseline and 6 months were similar (31.63 ± 3.49 versus 31.35 ± 4.61; p = 0.68). No difference in change of olfaction was seen compared with controls (Kendall tau-b p = 0.46). Conclusions Preservation of the olfactory strip can provide a low morbidity approach without adversely affecting olfaction and maintaining reconstruction options.",
author = "Harvey, {Richard J.} and Mark Winder and Andrew Davidson and Tim Steel and Sunny Nalavenkata and Nadine Mrad and Ali Bokhari and Henry Barham and Anna Knisely",
year = "2015",
month = "6",
day = "15",
doi = "10.1055/s-0035-1554905",
language = "English",
volume = "76",
pages = "464--470",
journal = "Journal of Neurological Surgery, Part B: Skull Base",
issn = "2193-634X",
publisher = "Thieme Medical Publishers",
number = "6",

}

The Olfactory Strip and Its Preservation in Endoscopic Pituitary Surgery Maintains Smell and Sinonasal Function. / Harvey, Richard J.; Winder, Mark; Davidson, Andrew; Steel, Tim; Nalavenkata, Sunny; Mrad, Nadine; Bokhari, Ali; Barham, Henry; Knisely, Anna.

In: Journal of Neurological Surgery, Part B: Skull Base, Vol. 76, No. 6, 15.06.2015, p. 464-470.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The Olfactory Strip and Its Preservation in Endoscopic Pituitary Surgery Maintains Smell and Sinonasal Function

AU - Harvey, Richard J.

AU - Winder, Mark

AU - Davidson, Andrew

AU - Steel, Tim

AU - Nalavenkata, Sunny

AU - Mrad, Nadine

AU - Bokhari, Ali

AU - Barham, Henry

AU - Knisely, Anna

PY - 2015/6/15

Y1 - 2015/6/15

N2 - Background The return of olfaction and of sinonasal function are important end points after pituitary surgery. Opinions differ on the impact of surgery because techniques vary greatly. A modified preservation of the so-called olfactory strip is described that utilizes a small nasoseptal flap and wide exposure. Methods A cohort of patients undergoing pituitary surgery and endoscopic sinonasal tumor surgery were assessed. Patient-reported outcomes (Sino-Nasal Outcome Test [SNOT22] and Nasal Symptom Score [NSS]) were recorded. A global score of sinonasal function and the impact on smell and taste were obtained. Objective smell discrimination testing was performed in the pituitary group with the Smell Identification Test. Outcomes were assessed at baseline and at 6 months. Results Ninety-eight patients, n = 40 pituitary (50.95 ± 15.31 years; 47.5% female) and n = 58 tumor (52.35 ± 18.51 years; 52.5% female) were assessed. For pituitary patients, NSSs were not significantly different pre- and postsurgery (2.75 ± 3.40 versus 3.05 ± 3.03; p = 0.53). SNOT22 scores improved postsurgery (1.02 ± 0.80 versus 0.83 ± 0.70; p = 0.046). Objective smell discrimination scores between baseline and 6 months were similar (31.63 ± 3.49 versus 31.35 ± 4.61; p = 0.68). No difference in change of olfaction was seen compared with controls (Kendall tau-b p = 0.46). Conclusions Preservation of the olfactory strip can provide a low morbidity approach without adversely affecting olfaction and maintaining reconstruction options.

AB - Background The return of olfaction and of sinonasal function are important end points after pituitary surgery. Opinions differ on the impact of surgery because techniques vary greatly. A modified preservation of the so-called olfactory strip is described that utilizes a small nasoseptal flap and wide exposure. Methods A cohort of patients undergoing pituitary surgery and endoscopic sinonasal tumor surgery were assessed. Patient-reported outcomes (Sino-Nasal Outcome Test [SNOT22] and Nasal Symptom Score [NSS]) were recorded. A global score of sinonasal function and the impact on smell and taste were obtained. Objective smell discrimination testing was performed in the pituitary group with the Smell Identification Test. Outcomes were assessed at baseline and at 6 months. Results Ninety-eight patients, n = 40 pituitary (50.95 ± 15.31 years; 47.5% female) and n = 58 tumor (52.35 ± 18.51 years; 52.5% female) were assessed. For pituitary patients, NSSs were not significantly different pre- and postsurgery (2.75 ± 3.40 versus 3.05 ± 3.03; p = 0.53). SNOT22 scores improved postsurgery (1.02 ± 0.80 versus 0.83 ± 0.70; p = 0.046). Objective smell discrimination scores between baseline and 6 months were similar (31.63 ± 3.49 versus 31.35 ± 4.61; p = 0.68). No difference in change of olfaction was seen compared with controls (Kendall tau-b p = 0.46). Conclusions Preservation of the olfactory strip can provide a low morbidity approach without adversely affecting olfaction and maintaining reconstruction options.

UR - http://www.scopus.com/inward/record.url?scp=84949497521&partnerID=8YFLogxK

U2 - 10.1055/s-0035-1554905

DO - 10.1055/s-0035-1554905

M3 - Article

VL - 76

SP - 464

EP - 470

JO - Journal of Neurological Surgery, Part B: Skull Base

T2 - Journal of Neurological Surgery, Part B: Skull Base

JF - Journal of Neurological Surgery, Part B: Skull Base

SN - 2193-634X

IS - 6

ER -