Predictors of Subjective Olfactory Dysfunction and Sinonasal Quality-of-Life After Endoscopic Transsphenoidal Pituitary Surgery.

Autor:	Naimi BR; Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Farquhar D; Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Duffy AN; Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Garvey EA; Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Kelly P; Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Kahn C; Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Doshi R; Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Shah R; Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Rabinowitz MR; Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Toskala E; Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Rosen M; Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Evans JJ; Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA., Nyquist GG; Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Jazyk:	angličtina
Zdroj:	American journal of rhinology & allergy [Am J Rhinol Allergy] 2024 Jul; Vol. 38 (4), pp. 223-229. Date of Electronic Publication: 2024 Apr 22.
DOI:	10.1177/19458924241243123
Abstrakt:	Background: This is the largest study in North America investigating olfactory outcomes after pituitary surgery to date. Objective: Characterize factors associated with subjective olfactory dysfunction (OD) and worsened sinonasal quality-of-life (QOL) after endoscopic TSA. Methods: Patients undergoing primary TSA for secreting and non-secreting pituitary adenomas between 2017 and 2021 with pre- and post-operative SNOT-22 scores were included. Subjective OD was determined by the smell/taste dysfunction question on the SNOT-22 (smell-SNOT). Results: 159 patients with pre- and post-operative SNOT-22 scores were included. Average total SNOT-22 scores worsened from pre-operative (16.91 ± 16.91) to POM1 (25.15 ± 20.83, P  < .001), with no difference from pre-operative (16.40 ± 15.88) to POM6 (16.27 ± 17.92, P  = .936) or pre-operative (13.63 ± 13.54) to POM12 (12.60 ± 16.45, P  = .651). Average smell-SNOT scores worsened from pre-operative (0.40 ± 1.27) to POM1 (2.09 ± 2.01, P  < .001), and pre-operative (0.46 ± 1.29) to POM6 (1.13 ± 2.45, P  = .002), with no difference from pre-operative (0.40 ± 1.07) to POM12 (0.71 ± 1.32, P  = .100). Female gender had a 0.9-point (95% CI 0.1 to 1.6) P  = .021, increase in smell-SNOT at POM1, resolving by POM6 (0.1 [-0.9 to 1.1], P  = .800) and POM12 (0.0 [-1.0 to 0.9], P  = .942). Septoplasty with tunnel approach had a 1.1 [0.2 to 2.0] out of 5-point ( P  = .023) increase in smell-SNOT at POM1, resolving by POM6 (0.2 [-1.1 to 1.6], P  = .764) and POM12 (0.4 [-0.9 to 1.6], P  = .567). Female gender had a 9.5 (4.0 to 15.1)-point ( P  = .001) increase in SNOT-22 scores at POM1, resolving by POM6 (3.4 [-3.0 to 9.8], P  = .292) and POM12 (6.4 [-5.4 to 18.2], P  = .276). Intra-operative CSF leak had an 8.6 [2.1 to 15.1]-point ( P  = .009) increase in SNOT-22 scores at POM1, resolving by POM6 (5.4 [-1.7 to 12.5], P  = .135), and POM12 (1.1 [-12.9 to 15.1], P  = .873). Conclusion: Changes in subjective olfaction and sinonasal QOL after TSA may be associated with gender, operative approach, and intra-operative CSF leak, resolving 6-12 months post-operatively. Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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