Effect of preservation versus resection of turbinate on olfactory function in endoscopic trans-nasal trans-sphenoidal pituitary surgery: a systematic review and meta-analysis

• Published in: Neurological research (New York) 2024-05, Vol.46 (5), p.444-452
• Main Authors: Al-Salihi, Mohammed Maan, Rahman, Mohammed, Al-Jebur, Maryam Sabah, Al-Salihi, Yezan, Shihadeh, Omar, Hammadi, Firas, Ayyad, Ali
• Format: Article
• Language: English
• Subjects: Endoscopy - methods; Humans; Hypophysectomy - adverse effects; Hypophysectomy - methods; Pituitary Gland - surgery; Pituitary Neoplasms - surgery; Smell - physiology; Turbinates - surgery
• ISSN: 0161-6412; 1743-1328
• DOI: 10.1080/01616412.2024.2328493

Utilizing endoscopes in surgery offers advantages and concerns, including potential nasal function impacts. Hyposmia following Transseptal Transsphenoidal hypophysectomy ranges from 0% to 2.2%. Debates persist about managing the M.T. in endoscopic sinus surgery due to its impact on nasal function. While preservation is recommended for sinonasal health, debates continue, as certain cases require resection. Our meta-analysis aims to compare turbinate resection and preservation effects on olfactory function. We searched five electronic databases to collect all relevant studies. Records were screened for eligibility. Data were extracted from the included studies independently. Our continuous outcomes were pooled as standardized mean difference with 95% CI. Statistical analyses was done by RevMan. Our meta-analysis included four studies involving 235 patients (81 males). Evaluating changes in olfaction scores, two one-month studies (82 patients) revealed no significant difference between preservation and resection groups (Std.MD = 0.05[-0.39, 0.50],  = 0.81). For three-month assessments (146 patients), SNOT tests indicated no significant difference (Std.MD = 0.21, 95% CI[-0.11, 0.54],  = 0.20). Two studies used other tests on 70 patients at three months, yielding no significant difference (Std.MD = 0.13, 95% CI [-0.35, 0.62],  = 0.59). Two six-month studies (72 patients) similarly found no significant difference (Std.MD = 0.09, 95% CI [-0.39, 0.56],  = 0.72). Our meta-analysis involving 235 patients examined olfaction score changes over various time frames in trans-nasal trans-sphenoidal pituitary surgeries. No significant differences were observed between turbinate preservation and resection groups at one month, three months, or six months post-surgery.