The Olfactory Strip and Its Preservation in Endoscopic Pituitary Surgery Maintains Smell and Sinonasal Function

January 25th, 2016

Richard J. Harvey, Mark Winder, Andrew Davidson, Tim Steel, Sunny Nalavenkata, Nadine Mrad, Ali Bokhari, Henry Barham, Anna Knisely (J Neurol Surg B 2015; 76(06): 464-470)

Olfactory Strip

The return of olfaction and of sinonasal function are important end points after pituitary surgery. Differing outcomes on olfaction have been reported from transsphenoidal approaches. In general, patients prefer the endoscopic approach, and olfactory scores are better after the endoscopic route. The nasoseptal flap, in particular, to reconstruct the skull base as part of the overall process has been implicated in smell dysfunction. However, much of the literature on the impact of the nasoseptal flap comes from extended skull base surgery. Controversy exists as to the additional morbidity of utilizing such an approach. This study presents the sinonasal, smell, and objective olfactory outcomes of a standardized olfactory strip preserving nasoseptal flap technique utilized in the endoscopic endonasal transsphenoidal approach to pituitary pathology.