Olfactory preservation during anterior interhemispheric approach for anterior skull base lesions: technical note

Anosmia is not a rare complication of surgeries that employ the anterior interhemispheric approach. Here, we present a fibrin-gelatin fixation method that provides reinforcement and moisture to help preserve the olfactory nerve when using the anterior interhemispheric approach and describe the resul...

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Bibliographic Details
Published in:Neurosurgical review 2016-01, Vol.39 (1), p.63-69
Main Authors: Matano, Fumihiro, Murai, Yasuo, Mizunari, Takayuki, Tateyama, Kojiro, Kobayashi, Shiro, Adachi, Koji, Kamiyama, Hiroyasu, Morita, Akio, Teramoto, Akira
Format: Article
Language:English
Subjects:
Adult
Aged
Craniopharyngioma - pathology
Craniopharyngioma - surgery
Craniotomy
Female
Fibrin
Gelatin
Humans
Intracranial Aneurysm - pathology
Intracranial Aneurysm - surgery
Male
Medicine
Medicine & Public Health
Meningioma - pathology
Meningioma - surgery
Middle Aged
Neurosurgery
Neurosurgical Procedures - adverse effects
Neurosurgical Procedures - methods
Olfaction Disorders - epidemiology
Olfaction Disorders - etiology
Olfaction Disorders - psychology
Olfactory Nerve Injuries - etiology
Olfactory Nerve Injuries - psychology
Original Article
Postoperative Complications - epidemiology
Postoperative Complications - psychology
Skull Base - surgery
Skull Base Neoplasms - surgery
Smell
Young Adult
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Summary:Anosmia is not a rare complication of surgeries that employ the anterior interhemispheric approach. Here, we present a fibrin-gelatin fixation method that provides reinforcement and moisture to help preserve the olfactory nerve when using the anterior interhemispheric approach and describe the results and outcomes of this technique. We analyze the outcomes with this technique in 45 patients who undergo surgery for aneurysms, brain tumors, or other pathologies via the anterior interhemispheric approach. Anosmia occurred in 4 patients (8.8 %); it was transient in 2 (4.4 %) and permanent in the remaining 2 (4.4 %). Brain tumors clearly attached to the olfactory nerve were resected in the patients with permanent anosmia. We found a significant difference in the presence of anosmia between patients with or without lesions that were attaching the olfactory nerve ( p  = 0.011). Our results suggested that fibrin-gelatin fixation method can reduce the reported risk of anosmia. However, the possibility of olfactory nerve damage is relatively high when operating on brain tumors attaching olfactory nerve.
ISSN:0344-5607
1437-2320
DOI:10.1007/s10143-015-0647-x