Prospective study comparing olfactory function in patients undergoing nasoseptal and rescue flap

Endoscopic skull base surgery, whether for treatment or reconstruction, can affect olfaction. Assessing whether the rescue flap technique leads to better olfactory recovery than the nasoseptal flap is essential for developing criteria to guide surgical flap selection. The primary objective of this study was to assess olfactory function in patients undergoing endoscopic skull base surgery with either a nasoseptal or rescue flap. The secondary objective was to evaluate nasal symptoms.

Olfactory and nasal symptom assessments were performed using the Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test and the Sino-nasal Outcome Test (SNOT-22) questionnaire at four time points: 24 h preoperatively, and at 1, 3, and 6 months postoperatively.

A total of 47 patients were included, divided into two groups: nasoseptal flap (n = 28) and rescue flap (n = 19). Both groups demonstrated preserved olfactory function and site-specific quality-of-life scores when comparing preoperative and 6-month postoperative data.

The results indicate that there was no significant change in olfactory function between groups over the evaluated time points, and no long-term deterioration in olfactory function or site-specific quality of life. Neither group demonstrated an earlier olfactory recovery that was statistically significant. Additionally, the SNOT-22 subdomains related to sleep disturbances and psychological symptoms showed progressive improvement, suggesting enhanced sleep quality and improved mental well-being.