Self-Reported Olfactory Outcomes in Transplanum and Transtuberculum Approaches
Zainab Balogun, Harish Dharmarajan, Anandraj Kanwar, paul gardner, Georgios Zenonos, Carl H. Snyderman, Katie Traylor, Eric W Wang- Neurology (clinical)
Objectives: Determine the clinical characteristics and cephalometric risk factors associated with decreased post-operative olfaction for transplanum and transtuberculum EEA patients. Methods: A retrospective cohort of 41 transplanum and transtuberculum EEA patients was divided into two groups based on the maximum change in post-operative SNOT22 olfaction score: prolonged olfactory loss group (n=5) with a ΔSNOT22 olfaction score of ≥ 4 without a return to baseline and a preserved olfaction group (n=36) with a ΔSNOT22 olfaction score ≤ 3 with return to baseline on follow-up of at least 3 months. Demographics, operative details, and cephalometric measurements were compared between the two groups. Results: There were no differences in terms of type of surgical approach (transplanum, transtuberculum), resection of turbinates (middle, superior), use of reconstructive flap (nasoseptal flap, reverse flap), or tumor pathology between the two groups. In the prolonged olfactory loss group, there was a smaller angle between the planum and face of sella (89.75° ± 9.18° vs. 107.17° ± 16.57°, p=0.05) and smaller angle between anterior nasal spine and sphenoid sinus face (21.20° ± 2.49° vs. 25.89° ± 4.90°, p=0.047) compared to preserved olfaction group. Conclusions: Patients with a narrow angle between planum and face of sella or a narrow angle between the anterior nasal spine and sphenoid sinus face are at a higher risk of prolonged olfactory dysfunction with transplanum and transtuberculum approaches.