Long-term Recovery Patterns of Olfactory Function after Trans-sphenoidal Approach with Nasoseptal Flap Elevation.

Area of Science:

• Otolaryngology
• Neurosurgery
• Skull Base Surgery

Background:

• Nasoseptal flaps are utilized for skull base reconstruction to prevent cerebrospinal fluid leaks.
• A debate exists regarding whether nasoseptal flap elevation causes more severe olfactory dysfunction compared to the conventional trans-sphenoidal approach.

Purpose of the Study:

• To compare the long-term olfactory function recovery patterns between the nasoseptal flap and conventional trans-sphenoidal approaches following skull base surgery.

Main Methods:

• A comparative study involving 31 patients undergoing trans-sphenoidal surgery.
• Patients were divided into conventional trans-sphenoidal approach and nasoseptal flap elevation groups.
• Olfactory function was assessed using the visual analogue scale and the Korean Version of the Sniffin Stick test II (TDI score) over 12 months, including olfactory training.

Main Results:

• Olfactory scores (visual analogue scale and TDI) recovered by 2 months in the conventional group and by 6 and 3 months, respectively, in the nasoseptal flap group.
• At 12 months post-surgery, no significant difference was found in visual analogue scale (9.3±0.5 vs 8.9±1.5) or TDI scores (28.5±4.3 vs 27.2±4.7) between the groups.
• Only one patient in the nasoseptal flap group experienced permanent olfactory dysfunction.

Conclusions:

• Olfactory function recovery is more gradual with the nasoseptal flap technique compared to the conventional trans-sphenoidal approach.
• Long-term olfactory outcomes are comparable between the two surgical methods, with no significant differences observed after six months.