Olfactory bulb volume changes associated with trans-sphenoidal pituitary surgery


Autoři: Dino Podlesek aff001;  Amir Zolal aff002;  Matthias Kirsch aff003;  Gabriele Schackert aff001;  Thomas Pinzer aff001;  Thomas Hummel aff004
Působiště autorů: Department of Neurosurgery, Dresden University of Technology, Carl Gustav Carus Faculty of Medicine, Dresden, Germany aff001;  Department of Spine Surgery and Neurotraumatology, SRH-Wald Clinic Gera, Gera, Germany aff002;  Department of Neurosurgery, Asklepios Clinic Schildautal Seesen, Germany aff003;  Interdisciplinary Smell & Taste Clinic, Department of Otorhinolaryngology, Dresden University of Technology, Carl Gustav Carus Faculty of Medicine, Dresden, Germany aff004
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224594

Souhrn

Objective

The trans-sphenoidal approach is most frequently used for pituitary adenoma (PA) enucleation. However, effects of this surgery on neighboring structures have received little attention so far. In particular, no investigations on olfactory bulb (OB) anatomy after trans-sphenoidal surgery have been reported. Because impairment of olfaction has been shown in small groups following trans-sphenoidal surgery we hypothesized that the transnasal approach is likely to alter OB volume which is associated with changes of olfactory function.

Methods

The study comprised 33 patients with pituitary adenoma (14 women and 19 men, mean age 50 years). Comprehensive assessment of olfactory function was conducted with the "Sniffin' Sticks" test kit. Based on magnetic resonance imaging scans OBs were measured before and approximately one year after trans-sphenoidal PA enucleation.

Results

Owing to postoperative non-compliance and MRI artifacts partly due to drill friction complete evaluation of “Sniffin' Sticks” in term of obtaining the TDI score was possible pre- and postoperatively in 21 patients whereas OB volumes were available in 32 patients. Approximately one year after surgery olfactory function was not significantly different from baseline. However, left- and right-sided OB volume in patients treated via trans-sphenoidal surgery decreased (p = 0.001). The side of the surgical approach did not affect OB volume in a side-specific manner. Changes in odor threshold were significantly correlated to changes in right-sided OB volume (r = 0.45, p = 0.024).

Conclusion

Overall olfactory performance one year after surgery was not significantly different from baseline. However, changes in OB volume are associated with changes in olfactory performance and OB volumes decreased in patients.

Klíčová slova:

Lesions – Magnetic resonance imaging – Olfactory bulb – Pituitary gland – Surgical and invasive medical procedures – Pituitary adenomas – Endocrine system procedures


Zdroje

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