Postoperative anosmia after anterior communicating artery aneurysms surgery by the pterional approach.

Damage to the olfactory nerve during the pterional approach to the anterior communicating artery aneurysms has not previously been investigated in a quantified manner. In this retrospective study, 100 patients with anterior communicating artery aneurysms, for whom the pterional approach was employed, were observed from the point of view of postoperative olfactory nerve function. In the postoperative period only three cases suffered from the impaired sense of smell ipsilateral to the side of surgery. 15 patients objectively showed olfactory nerve distinctions. The functions of olfactory nerve could be preserved at a relatively high rate of 85 per cent. This high rate resulted from the microtechnique employed as well as the relatively cautious frontal lobe retraction which was less than 1.5 cm.