Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta-analysis

Area of Science:

• Neurosurgery
• Otolaryngology
• Skull Base Surgery

Background:

• Olfactory dysfunction is a concern following skull base surgery.
• Endoscopic skull base surgery (ESBS) offers minimally invasive access to complex pathologies.
• Understanding the long-term impact of ESBS on olfaction is crucial for patient management.

Purpose of the Study:

• To determine the effect of endoscopic skull base surgery (ESBS) on long-term olfactory outcomes.
• To compare pre-operative and post-operative olfactory function using objective measures.

Main Methods:

• Systematic literature search of multiple databases (Cochrane, MEDLINE, Scopus, Embase) from 2000-2017.
• Inclusion of studies reporting subjective and objective olfaction outcomes in adult patients undergoing ESBS.
• Random-effects meta-analysis of objective olfactory outcomes (UPSIT, CCSIT) for sellar and parasellar ESBS.

Main Results:

• A meta-analysis of 29 articles (25 on sellar/parasellar tumors) was performed.
• No significant difference was found in pre-operative versus post-operative olfaction using UPSIT (MD = -1.03) and CCSIT (MD = -0.77).
• High heterogeneity (I² > 95%) was observed across meta-analyses, indicating significant study variations.

Conclusions:

• Published objective data suggest no significant change in olfaction after sellar and parasellar ESBS.
• Further prospective studies with validated objective measures are needed to clarify long-term olfactory outcomes.
• Improved understanding of olfactory impact post-ESBS is essential for surgical decision-making and patient counseling.