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Updated: May 15, 2026
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Risk factors for olfactory dysfunction after transsphenoidal pituitary adenoma resection: A systematic review and
Muyuan Jia1, Gaoyuan Cui1, Zhixiong Liu2
1Department of Neurosurgery, Xiangya Hospital Central South University, No. 87 Xiangya Road Kaifu District, Changsha, 410008, Hunan Province, P.R.China.
Summary
Postoperative olfactory dysfunction after pituitary adenoma surgery is linked to older age, smoking, and certain surgical reconstructions. Nasal irrigation may offer protection, but more research is needed.
Area of Science:
- Neurosurgery
- Otolaryngology
- Endocrinology
Background:
- Pituitary adenomas are common intracranial tumors treated via endonasal transsphenoidal resection.
- Postoperative olfactory dysfunction affects up to 30% of patients, significantly impacting quality of life.
- Risk factors for this dysfunction remain inconsistently documented.
Purpose of the Study:
- To systematically review and meta-analyze factors associated with olfactory dysfunction post-transsphenoidal pituitary adenoma surgery.
- Focus on patient characteristics, surgical techniques, reconstruction methods, and postoperative care.
- Provide evidence to guide clinical practice and future research.
Main Methods:
- PRISMA-compliant systematic review and meta-analysis.
- Searched major databases (PubMed, Embase, etc.) up to January 2026.
- Included RCTs and observational studies of adults without prior olfactory/neurological issues; data analyzed using R software.
Main Results:
- 11 studies with 802 participants were analyzed.
- Advanced age, smoking, and nasoseptal/nasal mucosal flap reconstruction increased dysfunction risk.
- Postoperative nasal irrigation showed a protective effect; endoscopic approach suggested higher risk than microsurgery (cautious interpretation needed).
Conclusions:
- Olfactory dysfunction is associated with patient, surgical, and management factors.
- Findings require cautious interpretation due to unadjusted data and limited study numbers.
- Further prospective studies with standardized assessments are necessary to confirm clinically relevant factors.
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