Olfactory Changes after Endoscopic Pituitary Tumor Resection

Abstract

OBJECTIVES: Given that the transnasal endoscopic approach to the sella involves resection of anatomical structures known to contain olfactory neuroepithelium, the effect of this approach on olfaction was evaluated. STUDY DESIGN: Case series with planned data collection. SETTING: Single tertiary care institution. SUBJECTS AND METHODS: Adults diagnosed with a pituitary mass and scheduled to undergo transnasal endoscopic resection underwent preoperative olfactory evaluation using the University of Pennsylvania Smell Identification Test (UPSIT). Repeat testing was performed at one and three months postoperatively. Paired Student t tests were used to compare preoperative and postoperative scores. RESULTS: A total of 57 consecutive patients were enrolled. Fifty patients (24 males, 26 females) completed olfactory evaluation at one month. Forty-five (23 males, 22 females) completed a three-month evaluation. The average UPSIT score (out of 40) was 31.8 preoperatively, 30.5 at one month, and 32.6 at three months. A significant difference was found between preoperative and one-month scores ( P = 0.01) but not three-month scores ( P = 0.08). CONCLUSION: A transient difference was found between preoperative and one month UPSIT scores. At three months, no clinically significant difference was found on repeat olfactory testing. Although the transnasal endoscopic approach to the sella removes structures known to contribute to olfactory function, it has no clinically significant effect on olfaction.