Olfactory Outcomes After Middle Turbinate Resection in Endoscopic Transsphenoidal Surgery: A Prospective Randomized...

Area of Science:

• Otolaryngology
• Neurosurgery
• Endoscopic Sinus Surgery

Background:

• Endoscopic endonasal transsphenoidal surgery is a standard procedure for sellar and parasellar tumors.
• Partial middle turbinate (MT) resection is sometimes employed to improve surgical access and postoperative care.
• The impact of MT resection on olfaction requires further investigation through randomized studies.

Purpose of the Study:

• To evaluate the effect of endoscopic endonasal transsphenoidal surgery on olfactory function.
• To compare olfactory outcomes between patients undergoing partial middle turbinate (MT) resection and those with MT preservation.

Main Methods:

• A prospective randomized trial was conducted at a single academic medical center.
• Patients underwent either partial resection of bilateral MTs or lateral fracture of bilateral MTs.
• Olfactory function was assessed using the Taiwan Smell Identification Test, and sinonasal conditions were evaluated with the Lund-Kennedy Endoscopy Score.

Main Results:

• Olfactory function showed a significant decrease at 1 month post-surgery (P < .01) but recovered by 3 months (P = .13) and 6 months (P = .79).
• No significant differences in olfactory outcomes were observed between the MT resection and preservation groups at any postoperative time point (1, 3, and 6 months).
• Sinonasal condition scores (Lund-Kennedy Endoscopy Score) were elevated at 3 months post-surgery but returned to baseline by 6 months.

Conclusions:

• Endoscopic endonasal transsphenoidal surgery can temporarily affect olfaction, with recovery expected by 3 months post-surgery.
• Partial middle turbinate (MT) resection does not lead to additional olfactory impairment.
• Partial MT resection is a safe surgical option during endoscopic endonasal transsphenoidal surgery without compromising olfactory outcomes.