Olfactory Recovery After Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Lesions: A Comprehensive Study

Li Yun Lim; Paul Patrick Berundang; Ing Ping Tang

Olfactory Recovery After Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Lesions: A Comprehensive Study

Abstract

Objective: The aim of this study was to evaluate the olfactory outcome in pituitary lesions after endoscopic endo- nasal transsphenoidal surgery. Methods: In this prospective study, the olfactory function of patients was assessed subjectively using visual analog scale (VAS) and objectively using “Smell and Scratch” smell test kit before surgery, followed by 6 weeks and 6 months after surgery. Results: Fourteen patients were included in this study, with 57% females and 43% males. The average age of the patients was 56.4 years. Thirteen cases were pituitary adenoma and 1 case was pituicytoma, while 64% were non- secreting tumors and 36% secreting type. The average tumor diameter operated on was 24.14 mm with 70% showing suprasellar extension. Nine cases had intraoperative cerebrospinal !uid leaks, which were repaired with nasoseptal !aps. Smell test kit results showed no changes in smell test kit scores across 3 time points: pre-surgery, 6 weeks post- surgery, and 6 months post-surgery (P = .29). However, patients’perception of olfaction was signi"cantly reduced using the VAS score pre-surgery and 6-weeks post-surgery (Z = !2.75, P = .006) while improved signi"cantly from 6 weeks post-surgery to 6-months post-surgery (Z = !2.49, P = .01). No statistical signi"cance in smell test kit score and VAS score di#erences was seen in di#erent age groups, genders, tumor types and location, and !ap usage intraoperatively. Conclusion: Olfactory outcomes post-surgery showed no signi"cant changes objectively, but subjectively, patient’s olfaction, evaluated with VAS, had shown notable e#ects.

Keywords

References

Reference 1. Landis$BN, Hummel$T, Lacroix$JS. Basic and clinical aspects of olfaction. Adv Tech Stand Neurosurg. 2005;30:69-105. [CrossRef]
Reference 2. Boesveldt$S, Parma$V. The importance of the olfactory system in human well- being, through nutrition and social behavior. Cell Tissue Res. 2021;383(1):559- 567. [CrossRef]
Reference 3. Collins$WF. Hypophysectomy: historical and personal perspective. Clin Neuro- surg. 1974;21:68-78. [CrossRef]
Reference 4. Liu$JK, Das$K, Weiss$MH, Laws$ER, Couldwell$WT. The history and evolution of transsphenoidal surgery. J Neurosurg. 2001;95(6):1083-1096. [CrossRef]
5. Halstead$AE. Remarks on the operative treatment of tumours of the hypophy- sis. With the report of two cases operated on by an oronasal method. Trans Am Surg Assoc. 1910;28:73-93.
6. Sharma$ BS, Ranwa$ A, Garg$ K. Complication avoidance in endonasal endoscopic pituitary surgery. Neurol India. 2020;68(suppl):S85-S91. [CrossRef]
7. Doty$RL. The Smell Identi"cation Test: Administration Manual. Sensonics, Incor- porated; 1995.
8. Tang$IP, Ngui$LX, Ramachandran$K, et$al. A 4-year review of surgical and onco- logical outcomes of endoscopic endonasal transpterygoid nasopharyngec- tomy in salvaging locally recurrent nasopharyngeal carcinoma. Eur Arch Otorhinolaryngol. 2019;276(9):2475-2482. [CrossRef]

9. Tang$IP, Carrau$RL, Otto$BA, et$al. Technical nuances of commonly used vas- cularised !aps for skull base reconstruction. J Laryngol Otol. 2015;129(8):752- 761. [CrossRef]
10. Leopold$ DA, Hummel$ T, Schwob$ JE, Hong$ SC, Knecht$ M, Kobal$ G. Anterior distribution of human olfactory epithelium. Laryngoscope. 2000;110(3 Pt 1):417-421. [CrossRef]
11. Wrobel$BB, Leopold$DA. Olfactory and sensory attributes of the nose. Otolar- yngol Clin North Am. 2005;38(6):1163-1170. [CrossRef].
12. Apuhan$T, Yıldırım$YS, %im&ek$T, Yılmaz$F, Yılmaz$F. Concha bullosa surgery and the distribution of human olfactory neuroepithelium. Eur Arch Otorhinolaryn- gol. 2013;270(3):953-957. [CrossRef]
13. 'smi$O, Me&e$F, Gür$H, et$al. Olfactory neuroepithelium in the middle turbinate: is there any impact on olfaction function after lateral marsupialization for concha bullosa surgery? Braz J Otorhinolaryngol. 2023;88(suppl 5):12-18.
14. Harvey$RJ, Winder$M, Davidson$A, et$al. The olfactory strip and its preservation in endoscopic pituitary surgery maintains smell and sinonasal function. J Neu- rol Surg B Skull Base. 2015;76(6):464-470. [CrossRef]
15. Ainer$I, Husain$S, Hamizan$AK, Zahedi$FD, Thanabalan$J. Olfactory and gusta- tory outcomes following endoscopic transsphenoidal hypophysectomy. Egypt J Otolaryngol. 2023;39(1):62. [CrossRef]
16. Hart$CK, Theodosopoulos$PV, Zimmer$LA. Olfactory changes after endoscopic pituitary tumour resection. Otolaryngol Head Neck Surg. 2010;142(1):95-97. [CrossRef]
17. Li$P, Luo$K, Zhang$Q, Wang$Z. Superior turbinate management and olfactory outcome after endoscopic endonasal transsphenoidal surgery for pituitary adenoma: a propensity score–matched cohort study. Int Forum Allergy Rhinol. 2020;10(12):1276-1284. [CrossRef]
18. Sowerby$LJ, Gross$M, Broad$R, Wright$ED. Olfactory and sinonasal outcomes in endoscopic transsphenoidal skull(base surgery. Int Forum Allergy Rhinol. 2013;3(3):217-220. [CrossRef]
19. Rotenberg$BW, Saunders$S, Duggal$N. Olfactory outcomes after endoscopic transsphenoidal pituitary surgery. Laryngoscope. 2011;121(8):1611-1613. [CrossRef].
20. Yin$LX, Low$CM, Puccinelli$CL, et$al. Olfactory outcomes after endoscopic skull base surgery: a systematic review and meta-analysis. Laryngoscope. 2019;129(9):1998-2007. [CrossRef]
21. Kuwata$F, Kikuchi$M, Ishikawa$M, et$al. Long-term olfactory function outcomes after pituitary surgery by endoscopic endonasal transsphenoidal approach. Auris Nasus Larynx. 2020;47(2):227-232. [CrossRef]

Details

Primary Language

English

Subjects

Allergy

Journal Section

Research Article

Authors

Li Yun Lim This is me
Malaysia

Paul Patrick Berundang This is me
Malaysia

Ing Ping Tang This is me
Malaysia

Publication Date

April 20, 2025

Submission Date

October 22, 2024

Acceptance Date

November 27, 2024

Published in Issue

Year 2025 Volume: 8 Number: 1

IZ

https://izlik.org/JA32AZ47YR

Cite

RIS / Bibtex

APA

Lim, L. Y., Berundang, P. P., & Tang, I. P. (2025). Olfactory Recovery After Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Lesions: A Comprehensive Study. European Journal of Rhinology and Allergy, 8(1), 19-25. https://izlik.org/JA32AZ47YR

AMA

1.Lim LY, Berundang PP, Tang IP. Olfactory Recovery After Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Lesions: A Comprehensive Study. Eur J Rhinol Allergy. 2025;8(1):19-25. https://izlik.org/JA32AZ47YR

Chicago

Lim, Li Yun, Paul Patrick Berundang, and Ing Ping Tang. 2025. “Olfactory Recovery After Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Lesions: A Comprehensive Study”. European Journal of Rhinology and Allergy 8 (1): 19-25. https://izlik.org/JA32AZ47YR.

EndNote

Lim LY, Berundang PP, Tang IP (April 1, 2025) Olfactory Recovery After Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Lesions: A Comprehensive Study. European Journal of Rhinology and Allergy 8 1 19–25.

IEEE

[1]L. Y. Lim, P. P. Berundang, and I. P. Tang, “Olfactory Recovery After Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Lesions: A Comprehensive Study”, Eur J Rhinol Allergy, vol. 8, no. 1, pp. 19–25, Apr. 2025, [Online]. Available: https://izlik.org/JA32AZ47YR

ISNAD

Lim, Li Yun - Berundang, Paul Patrick - Tang, Ing Ping. “Olfactory Recovery After Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Lesions: A Comprehensive Study”. European Journal of Rhinology and Allergy 8/1 (April 1, 2025): 19-25. https://izlik.org/JA32AZ47YR.

JAMA

1.Lim LY, Berundang PP, Tang IP. Olfactory Recovery After Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Lesions: A Comprehensive Study. Eur J Rhinol Allergy. 2025;8:19–25.

MLA

Lim, Li Yun, et al. “Olfactory Recovery After Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Lesions: A Comprehensive Study”. European Journal of Rhinology and Allergy, vol. 8, no. 1, Apr. 2025, pp. 19-25, https://izlik.org/JA32AZ47YR.

Vancouver

1.Li Yun Lim, Paul Patrick Berundang, Ing Ping Tang. Olfactory Recovery After Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Lesions: A Comprehensive Study. Eur J Rhinol Allergy [Internet]. 2025 Apr. 1;8(1):19-25. Available from: https://izlik.org/JA32AZ47YR