Abstract

Background: The endoscopic endonasal approach (EEA) is the preferred surgical option for sellar, parasellar, and suprasellar tumors. However, olfactory function in elderly patients after EEA surgery has not been well investigated.

Methods: We retrospectively collected data from 45 patients who received EEA surgery for sellar, parasellar, or suprasellar tumors between 2016 and 2018. We divided patients into the non-elderly (20–59 years; n = 29) and elderly (≥ 60 years; n = 16) groups. We analyzed preoperative and postoperative olfactory function (Taiwan Smell Identification Test [TWSIT] score) and sinonasal endoscopic appearance (Lund-Kennedy Endoscopic Score, LKES).

Results: The 1-month postoperative TWSIT score in the non-elderly group and the 1-month and 3- month postoperative TWSIT scores in the elderly group were lower than the corresponding preoperative baseline scores, albeit without statistical significance. The 2-week, 1-month, and 2-month postoperative LKES were higher than the corresponding preoperative baseline LKES in both groups. They were statistically significant in the non-elderly group but not in the elderly group. The preoperative baseline TWSIT scores were lower in the elderly group than in the non-elderly group. The postoperative TWSIT score and LKES were similar between the two groups.

Conclusion: In patients undergoing EEA surgery, there is a trend toward decreasing sense of smell at 1 month postoperatively, but it returns to the preoperative baseline level within 6 months in both nonelderly and elderly patients. This may be related to sinonasal scarring and crusting. There was no difference between the elderly and non-elderly groups in the postoperative change in smell function.