Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Oper Neurosurg (Hagerstown). 2021 Aug 16;21(3):137-142. doi: 10.1093/ons/opab137.
As endoscopic endonasal skull base surgery (EESBS) for sellar pathology has become routine, there is increasing awareness of quality-of-life (QOL) outcomes related to this approach. Similarly, there is a growing interest in postoperative chemosensory function, with notable emphasis on olfaction and the corresponding psychosocial implications of olfactory dysfunction. Meanwhile, there has been minimal direct investigation into gustatory outcomes, and the association between these 2 chemosensory functions remains poorly understood.
To investigate patient-reported chemosensory function and rhinologic-specific QOL following EESBS for routine sellar pathologies.
Comprehensive clinical characteristics and sinonasal QOL assessments, measured using Anterior Skull Base Nasal Inventory-12 (ASK Nasal-12), were collected from 46 patients undergoing EESBS for sellar pathology.
Forty-six patients were included: 65.2% female, average age 52.8 yr (range: 27-89). The most common pathology was nonfunctioning pituitary adenoma (n = 28). Preoperative ASK Nasal-12 scores (mean = 0.81) demonstrated postoperative worsening at 2 wk (mean = 2.52, P < .0001) and 1 mo (mean = 1.33, P = .0031), with no difference at 3 mo postoperatively (mean = 0.89, P = .92). Meanwhile, there was significant worsening of preoperative subjective smell (mean = 0.62) and taste function (mean = 0.42) at 2 wk (mean = 3.48, P < .0001; mean = 2.69, P < .0001) and 1 mo (mean = 2.40, P < .0001; mean = 2.03, P < .0001) postoperatively, which persisted at approximately 3 mo postoperatively (mean = 1.26, P = .04; mean = 1.15, P = .0059).
Patients undergoing EESBS for sellar pathologies experience anticipated, temporary disruptions in sinonasal QOL but may have longer lasting perturbations in subjective olfaction and gustation. Given the increasing use of the endoscopic endonasal corridor, further investigation in postoperative chemosensory function is essential.
随着内镜经鼻颅底手术（EESBS）治疗鞍区病变成为常规手术，人们越来越关注与该手术相关的生活质量（QOL）结果。同样，人们对术后嗅觉和味觉功能越来越感兴趣，尤其是嗅觉和与之相关的嗅觉功能障碍的心理社会影响。与此同时，对于味觉结果的直接研究很少，这两种化学感觉功能之间的关系仍知之甚少。
研究内镜经鼻颅底手术（EESBS）治疗常规鞍区病变后患者报告的化学感觉功能和鼻颅底特定生活质量（QOL）。
对 46 例因鞍区病变而行 EESBS 的患者进行了全面的临床特征和鼻颅底 QOL 评估，使用前颅底鼻腔问卷 12 项（ASK Nasal-12）进行测量。
46 例患者纳入研究：女性占 65.2%，平均年龄 52.8 岁（范围：27-89 岁）。最常见的病变是非功能性垂体腺瘤（n=28）。术前 ASK Nasal-12 评分（平均=0.81）在术后 2 周（平均=2.52，P<0.0001）和 1 个月（平均=1.33，P=0.0031）时恶化，术后 3 个月无差异（平均=0.89，P=0.92）。同时，术前主观嗅觉（平均=0.62）和味觉功能（平均=0.42）在术后 2 周（平均=3.48，P<0.0001；平均=2.69，P<0.0001）和 1 个月（平均=2.40，P<0.0001；平均=2.03，P<0.0001）时明显恶化，术后约 3 个月时仍持续存在（平均=1.26，P=0.04；平均=1.15，P=0.0059）。
接受 EESBS 治疗鞍区病变的患者经历了预期的、暂时的鼻颅底 QOL 破坏，但可能会对主观嗅觉和味觉产生持久的影响。鉴于内镜经鼻颅底入路的应用越来越广泛，进一步研究术后嗅觉和味觉功能至关重要。
