Jang Woo-Youl, Jung Shin, Jung Tae-Young, Moon Kyung-Sub, Kim In-Young
Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital and Medical School, Gwangju, South Korea.
Clin Neurol Neurosurg. 2013 Aug;115(8):1288-92. doi: 10.1016/j.clineuro.2012.12.004. Epub 2013 Jan 10.
Olfaction is commonly considered as secondary among the sensory functions, perhaps reflecting a lack of interest in sparing olfaction after surgery for the olfactory groove meningiomas (OGM). However, considering the repercussions of olfaction for the quality of life, the assessment of post-operative olfaction should be necessary. We retrospectively reviewed the olfactory outcome in patients with OGM and investigated the factors associated with sparing the post-operative olfaction.
Between 1993 and 2012, 40 patients with OGM underwent surgical resection and estimated the olfactory function using the Korean version of "Sniffin'Sticks" test (KVSS). Variable factors, such as tumor size, degree of preoperative edema, tumor consistency, preoperative olfactory function, surgical approaches, patient's age, and gender were analyzed with attention to the post-operative olfactory function.
Anatomical and functional preservation of olfactory structures were achieved in 26 patients (65%) and 22 patients (55%), respectively. Among the variable factors, size of tumor was significant related to the preservation of post-operative olfaction. (78.6% in size<4 cm and 42.3% in size>4 cm, p=0.035). Sparing the olfaction was significantly better in patients without preoperative olfactory dysfunction (84.6%) compared with ones with preoperative olfactory dysfunction (40.7%, p=0.016). The frontolateral approach achieved much more excellent post-operative olfactory function (71.4%) than the bifrontal approach (36.8%, p=0.032).
If the tumor was smaller than 4 cm and the patients did not present olfactory dysfunction preoperatively, the possibility of sparing the post-operative olfaction was high. Among the variable surgical approaches, frontolateral route may be preferable sparing the post-operative olfaction.
嗅觉通常被认为是次要的感觉功能，这可能反映出在嗅沟脑膜瘤（OGM）手术后对保留嗅觉缺乏关注。然而，考虑到嗅觉对生活质量的影响，术后嗅觉评估是必要的。我们回顾性分析了OGM患者的嗅觉结果，并研究了与术后嗅觉保留相关的因素。
1993年至2012年间，40例OGM患者接受了手术切除，并使用韩语版“嗅觉棒”测试（KVSS）评估嗅觉功能。分析了肿瘤大小、术前水肿程度、肿瘤质地、术前嗅觉功能、手术入路、患者年龄和性别等可变因素与术后嗅觉功能的关系。
分别有26例（65%）和22例（55%）患者实现了嗅觉结构的解剖学和功能保留。在可变因素中，肿瘤大小与术后嗅觉保留显著相关。（肿瘤大小<4 cm者为78.6%，>4 cm者为42.3%，p = 0.035）。与术前有嗅觉功能障碍的患者（40.7%，p = 0.016）相比，术前无嗅觉功能障碍的患者嗅觉保留明显更好（84.6%）。额外侧入路的术后嗅觉功能（71.4%）比双额入路（36.8%）要好得多（p = 0.032）。
如果肿瘤小于4 cm且患者术前无嗅觉功能障碍，则术后保留嗅觉的可能性较高。在各种可变手术入路中，额外侧入路可能更有利于保留术后嗅觉。
