Olfactory functions after transsphenoidal pituitary surgery: endoscopic versus microscopic approach

Area of Science:

• Neurosurgery
• Otolaryngology
• Endocrinology

Background:

• Olfactory disturbances are a potential complication of transsphenoidal pituitary surgery.
• Comparative data on olfactory function between endoscopic and microscopic approaches is lacking.

Purpose of the Study:

• To compare olfactory function following endoscopic versus microscopic transsphenoidal pituitary surgery.
• To evaluate the impact of cerebrospinal fluid leakage and synechiae on olfaction.

Main Methods:

• Prospective study involving 50 patients (25 endoscopic, 25 microscopic).
• Olfactory function assessed using the Smell Diskettes Olfaction Test preoperatively and at 1 and 6 months postoperatively.
• Statistical analysis included Friedman, Mann-Whitney, and Chi-Square tests.

Main Results:

• The endoscopic group had significantly fewer olfactory disturbances (hyposmia/anosmia) than the microscopic group (P <0.05).
• No significant difference in olfactory disturbances related to cerebrospinal fluid leakage between groups (P >0.05).
• Significantly fewer synechiae and associated olfactory disturbances were observed in the endoscopic group (P <0.05).

Conclusions:

• The endoscopic approach appears more advantageous for preserving olfactory system function during pituitary surgery.
• Endoscopic pituitary surgery demonstrates superior outcomes in protecting olfactory function compared to the microscopic technique.