Abstract
We assessed recovery of olfactory function in five consecutive patients who underwent surgical resection of midline skull base tumors using an anterior craniofacial approach in which the cribriform plate was mobilized with the dura. Olfactory function was evaluated before and after surgery using an intravenous olfactory test with prosultiamine and also a standard olfactory acuity test. Before surgery, one patient showed anosmia attributable to obstruction of the nasal cavity and olfactory cleft, and four patients showed normal olfactory function. After surgery, one patient was irreversibly anosmic, probably because of intradural dissection of the olfactory tracts. The other four patients, including the patient showing anosmia preoperatively, reported subjective recovery of olfaction 3 to 8 weeks after surgery. Intravenous and standard olfactory acuity tests indicated recovery of olfaction to the normal range in three patients and decreased olfactory function in one. With careful preservation of the olfactory system and of the integrity of the nasal cavity, olfactory function was found to recover after skull base resections via the anterior craniofacial approach.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Blacklock J. B., Weber R. S., Lee Y. Y., Goepfert H. Transcranial resection of tumors of the paranasal sinuses and nasal cavity. J Neurosurg. 1989 Jul;71(1):10–15. doi: 10.3171/jns.1989.71.1.0010. [DOI] [PubMed] [Google Scholar]
- Douek E. E. Smell: recent theories and their clinical application. J Laryngol Otol. 1967 Apr;81(4):431–439. doi: 10.1017/s0022215100067281. [DOI] [PubMed] [Google Scholar]
- Fukuta K., Saito K., Takahashi M., Torii S. Surgical approach to midline skull base tumors with olfactory preservation. Plast Reconstr Surg. 1997 Aug;100(2):318–325. doi: 10.1097/00006534-199708000-00006. [DOI] [PubMed] [Google Scholar]
- Kimmelman C. P. The risk to olfaction from nasal surgery. Laryngoscope. 1994 Aug;104(8 Pt 1):981–988. doi: 10.1288/00005537-199408000-00012. [DOI] [PubMed] [Google Scholar]
- Saito K., Fukuta K., Takahashi M., Seki Y., Yoshida J. Benign fibroosseous lesions involving the skull base, paranasal sinuses, and nasal cavity. Report of two cases. J Neurosurg. 1998 Jun;88(6):1116–1119. doi: 10.3171/jns.1998.88.6.1116. [DOI] [PubMed] [Google Scholar]
- Sekhar L. N., Nanda A., Sen C. N., Snyderman C. N., Janecka I. P. The extended frontal approach to tumors of the anterior, middle, and posterior skull base. J Neurosurg. 1992 Feb;76(2):198–206. doi: 10.3171/jns.1992.76.2.0198. [DOI] [PubMed] [Google Scholar]
- Shibuya M., Takayasu M., Suzuki Y., Saito K., Sugita K. Bifrontal basal interhemispheric approach to craniopharyngioma resection with or without division of the anterior communicating artery. J Neurosurg. 1996 Jun;84(6):951–956. doi: 10.3171/jns.1996.84.6.0951. [DOI] [PubMed] [Google Scholar]
- Spetzler R. F., Herman J. M., Beals S., Joganic E., Milligan J. Preservation of olfaction in anterior craniofacial approaches. J Neurosurg. 1993 Jul;79(1):48–52. doi: 10.3171/jns.1993.79.1.0048. [DOI] [PubMed] [Google Scholar]
- Sztamska E., Goetzen B. Comparative anatomy of arterial vascularization of the rhinencephalon in man, cat and sheep. Folia Neuropathol. 1997;35(1):60–68. [PubMed] [Google Scholar]