Olfaction preservation in anterior cranial base approaches: an anatomic study

Area of Science:

• Neurosurgery
• Anatomy
• Histology

Background:

• Anterior cranial base approaches are used for tumor resection and other neurosurgical procedures.
• Preserving olfactory function is a critical consideration in these approaches.
• The precise anatomical course of olfactory nerves is crucial for developing nerve-sparing techniques.

Purpose of the Study:

• To investigate the anatomical basis of olfaction-sparing anterior cranial base approaches.
• To determine the location, distribution, and depth of olfactory nerves within the anterior skull base.
• To evaluate the impact of surgical techniques on olfactory nerve integrity.

Main Methods:

• Cadaveric dissection of the medial anterior skull base.
• Histological analysis using Hematoxylin and eosin, Gomori trichrome, and S-100 immunostaining.
• Evaluation of olfactory nerve transection in simulated olfaction-sparing craniofacial approaches.

Main Results:

• Olfactory nerves are predominantly located in the nasal septum and middle turbinate.
• Nerve endings extend up to 20 mm below the cribriform plate, primarily in the superior and middle nasal meatus.
• Histological examination revealed routine transection of olfactory nerves during simulated olfaction-sparing approaches.

Conclusions:

• Olfactory nerves are consistently transected in current olfaction-sparing anterior cranial base approaches.
• The clinical significance of this nerve transection on postoperative olfactory function requires further investigation.