Related Experiment Video
Updated: Dec 22, 2025
09:53
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
4.0K
Risk Factors for Patient-Reported Olfactory Dysfunction After Endoscopic Transsphenoidal Hypophysectomy.
Jake J Lee1, Zindzi S Thompson1,2, Jay F Piccirillo1,3
1Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.
JAMA Otolaryngology-- Head & Neck Surgery
|May 8, 2020
Summary
Abdominal fat grafting and smoking history are risk factors for olfactory dysfunction after endoscopic transsphenoidal hypophysectomy (ETSH). A wider skull base angle may be protective, and recovery of smell function improves over time post-ETSH.
Area of Science:
- Otolaryngology
- Neurosurgery
- Endocrinology
Background:
- Iatrogenic olfactory dysfunction is an underrecognized complication of endoscopic transsphenoidal hypophysectomy (ETSH).
- Risk factors for this complication remain poorly understood.
Purpose of the Study:
- To identify demographic, comorbidity, cephalometric, intraoperative, histological, and postoperative predictors of patient-reported olfactory dysfunction after ETSH.
- To investigate the association between skull base and sinonasal anatomy and olfactory outcomes.
Main Methods:
- Retrospective cohort study of 147 patients undergoing ETSH for sellar lesions.
- Patient-reported outcomes assessed via telephone survey using a 7-point smell change scale.
- Multivariable analysis to determine independent prognostic factors.
Main Results:
- 29% of patients reported olfactory dysfunction post-ETSH.
- Abdominal fat grafting (aRR 2.95) and smoking history (aRR 1.54) were associated with olfactory dysfunction.
- A more obtuse angle between the planum sphenoidale and sella turcica was protective (aRR 0.98).
- Increased time since ETSH correlated with improved smell (aRR 0.93).
Conclusions:
- Abdominal fat grafting, smoking history, and skull base angle are significant factors influencing olfactory dysfunction after ETSH.
- Time elapsed since surgery appears to improve olfactory outcomes.
More Related Videos
Related Concept Videos
01:03Olfactory Receptors: Location and Structure
11.0K
The process of olfaction, also known as the sense of smell, is a sophisticated chemical response system. The specialized sensory neurons that facilitate this process, known as olfactory receptor neurons, are situated in an upper segment of the nasal cavity, known as the olfactory epithelium. Olfactory sensory neurons are bipolar, with their dendrites extending from the epithelium's apex into the mucus that lines the nasal cavity. Airborne molecules, when inhaled, traverse the olfactory...
11.0K
01:25Olfaction
47.8K
The sense of smell is achieved through the activities of the olfactory system. It starts when an airborne odorant enters the nasal cavity and reaches olfactory epithelium (OE). The OE is protected by a thin layer of mucus, which also serves the purpose of dissolving more complex compounds into simpler chemical odorants. The size of the OE and the density of sensory neurons varies among species; in humans, the OE is only about 9-10 cm2.
The olfactory receptors are embedded in the cilia of the...
The olfactory receptors are embedded in the cilia of the...
47.8K
01:23Chronic Pharyngitis
9.5K
Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
9.5K
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
406
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
406
01:23Tracheostomy Suctioning II: Procedure
1.2K
Tracheostomy suctioning is a vital nursing procedure that involves removing secretions from the tracheostomy tube to maintain airway patency and prevent respiratory complications. Nurses need to understand the proper technique for tracheostomy suctioning to ensure patient safety and comfort. In this guide, we will outline the step-by-step process for performing tracheostomy suctioning, including preparing the sterile field, donning personal protective equipment (PPE), lubricating and connecting...
1.2K
01:29Suctioning the Nasopharyngeal Airway
2.4K
Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
Equipment Required
Equipment Required
2.4K