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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Olfactory bulb volume changes associated with trans-sphenoidal pituitary surgery.
Dino Podlesek1, Amir Zolal2, Matthias Kirsch3
1Department of Neurosurgery, Dresden University of Technology, Carl Gustav Carus Faculty of Medicine, Dresden, Germany.
Plos One
|December 19, 2019
Summary
Transsphenoidal surgery for pituitary adenomas can reduce olfactory bulb volume, potentially impacting smell function. This study found decreased olfactory bulb size one year post-surgery, linked to olfactory performance changes.
Area of Science:
- Neurosurgery
- Otolaryngology
- Neuroscience
Background:
- Transsphenoidal surgery is the primary method for pituitary adenoma (PA) removal.
- The impact of this surgery on adjacent anatomical structures, particularly the olfactory bulb (OB), remains under-investigated.
- Olfactory dysfunction has been observed in some patients post-transsphenoidal surgery.
Purpose of the Study:
- To investigate the anatomical changes in the olfactory bulb (OB) following transsphenoidal surgery for pituitary adenomas (PAs).
- To assess the association between alterations in OB volume and olfactory function after surgery.
- To test the hypothesis that the transnasal surgical approach alters OB volume, affecting olfactory function.
Main Methods:
- 33 patients with PAs underwent transsphenoidal surgery.
- Olfactory function was assessed using the "Sniffin' Sticks" test before and approximately one year after surgery.
- Olfactory bulb (OB) volumes were measured using MRI scans pre- and post-surgery.
Main Results:
- While overall olfactory function did not significantly change one year post-surgery, a significant decrease in left- and right-sided OB volumes was observed (p = 0.001).
- No side-specific effect of the surgical approach on OB volume was detected.
- Changes in odor threshold were significantly correlated with changes in right-sided OB volume (r = 0.45, p = 0.024).
Conclusions:
- Transsphenoidal surgery for pituitary adenomas leads to a reduction in olfactory bulb volume.
- The observed decrease in OB volume is associated with alterations in olfactory performance, even if overall function remains statistically unchanged.
- Further research is warranted to fully understand the long-term implications of these anatomical changes on olfactory perception.
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