Lee Jae Yoon, Park Jae Sung, Jeun Sin Soo, Kim Sung Won, Kim Do Hyun, Kim Soo Whan
Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Neurosurgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
PLoS One. 2025 Jan 2;20(1):e0316263. doi: 10.1371/journal.pone.0316263. eCollection 2025.
Endoscopic endonasal transsphenoidal surgery is widely used to resect pituitary adenomas, yet its impact on olfactory function after resection of the posterosuperior nasal septum remains a concern. To optimize surgical techniques to preserve olfactory function, it is essential to understand the relationship between the extent of septal resection and olfactory outcomes.
This retrospective study analyzed 295 patients who underwent pituitary adenoma surgery. The extent of nasal septum resection was quantified and its impact on olfactory function was assessed using the Cross-Cultural Smell Identification Test (CCSIT), Sino-Nasal Outcome Test-22 (SNOT-22), and a Visual Analog Scale (VAS) for olfactory loss. Preoperative and 6-month postoperative scores were compared to evaluate changes in olfactory function.
There was a significant correlation between larger septal resections and greater reductions in CCSIT scores, indicating a decline in olfactory function. Furthermore, patients with more extensive septal resections reported increased discomfort and olfactory loss, as evidenced by higher SNOT-22 and VAS scores. These findings highlight the importance of the nasal septum in maintaining laminar airflow and its role in olfactory function.
Study underscores the adverse effects of extensive posterior septectomy on olfactory outcomes. Minimizing the extent of septal resection may help preserve olfactory function, suggesting a need for surgical strategies that maintain septum integrity to reduce the risk of postoperative olfactory impairment.
鼻内镜下经鼻蝶窦手术广泛用于切除垂体腺瘤，然而其对切除后上鼻中隔后嗅觉功能的影响仍令人担忧。为优化手术技术以保留嗅觉功能，了解鼻中隔切除范围与嗅觉结果之间的关系至关重要。
这项回顾性研究分析了295例行垂体腺瘤手术的患者。对鼻中隔切除范围进行量化，并使用跨文化嗅觉识别测试（CCSIT）、鼻-鼻窦结局测试-22（SNOT-22）和嗅觉丧失视觉模拟量表（VAS）评估其对嗅觉功能的影响。比较术前和术后6个月的评分，以评估嗅觉功能的变化。
较大范围的鼻中隔切除与CCSIT评分的更大降低之间存在显著相关性，表明嗅觉功能下降。此外，鼻中隔切除范围更广的患者报告不适和嗅觉丧失增加，SNOT-22和VAS评分更高证明了这一点。这些发现突出了鼻中隔在维持层流气流中的重要性及其在嗅觉功能中的作用。
研究强调了广泛的后鼻中隔切除术对嗅觉结果的不利影响。尽量减少鼻中隔切除范围可能有助于保留嗅觉功能，这表明需要采取保持鼻中隔完整性的手术策略以降低术后嗅觉障碍的风险。
