Temporary Nasal Morbidity after Expanded Endoscopic Endonasal Surgery for Skull Base Tumors

Area of Science:

• Neurosurgery
• Otolaryngology
• Skull Base Surgery

Background:

• Skull base tumors often require complex surgical interventions.
• The expanded endoscopic endonasal approach (EEA) offers minimally invasive access to skull base lesions.
• Assessing the impact of EEA on olfactory function and quality of life (QOL) is crucial for patient outcomes.

Purpose of the Study:

• To evaluate olfactory dysfunction and QOL in patients undergoing EEA for skull base tumors.
• To determine the short-term and medium-term effects of EEA on smell perception and nasal well-being.

Main Methods:

• Prospective observational study involving 29 patients undergoing EEA for anterior skull base and pituitary lesions.
• Olfactory function assessed using the Connecticut Chemosensory Clinical Research Centre olfaction test.
• QOL evaluated using the Sino Nasal Outcome Test 22 (SNOT-22) questionnaire.
• Assessments conducted preoperatively and at 2 weeks and 3 months postoperatively.

Main Results:

• Olfactory scores significantly worsened at 2 weeks postoperatively compared to preoperative baseline.
• By 3 months, 48% of patients returned to baseline olfaction, 48% had mild hyposmia, and 1 had moderate hyposmia.
• QOL scores significantly declined immediately postoperatively, showing improvement at 3 months but not reaching preoperative levels.

Conclusions:

• EEA for anterior skull base tumors leads to transient olfactory dysfunction and nasal morbidity.
• While most patients experience improvement, approximately 50% may have mild residual olfactory dysfunction at 3 months.
• Olfactory epithelium-preserving techniques, postoperative nasal care, and douching may improve olfactory outcomes.