Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta-analysis

Linda X. Yin; Christopher M. Low; Cassandra L. Puccinelli; Erin K. O'Brien; Janalee K. Stokken; Kathryn M. Van Abel; Jeffrey R. Janus; Michael J. Link; Jamie J. Van Gompel; Garret Choby

doi:10.1002/lary.28003

Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta-analysis

Linda X. Yin, Christopher M. Low, Cassandra L. Puccinelli, Erin K. O'Brien, Janalee K. Stokken, Kathryn M. Van Abel, Jeffrey R. Janus, Michael J. Link, Jamie J. Van Gompel, Garret Choby

Neurosurgery

Research output: Contribution to journal › Review article › peer-review

9 Scopus citations

Abstract

Objectives: Determine the effect of endoscopic skull base surgery (ESBS) on long-term olfactory outcomes after surgery. Methods: An English-language search was conducted using the Cochrane, MEDLINE, Scopus, and Embase databases from January 2000 to October 2017 for adult patients undergoing ESBS with subjective and objective olfaction outcomes. Two authors independently examined articles to identify those meeting inclusion criteria. Studies examining objective olfactory outcomes after ESBS were included in the meta-analysis. A random-effects meta-analysis of patients undergoing sellar and parasellar ESBS was conducted to compare preoperative and postoperative olfactory outcomes using the University of Pennsylvania Smell Identification Test (UPSIT) and Cross-Cultural Smell Identification Test (CCSIT). Results: Among 339 eligible articles, 29 articles met inclusion criteria. Twenty-five of these focused on sellar and parasellar tumors. Individual articles not meeting criteria for meta-analysis were qualitatively reported. Meta-analysis showed there was no difference in preoperative and postoperative olfactory function after sellar and parasellar ESBS based on the UPSIT (five studies, mean difference [MD] = −1.03; 95% CI: −3.98, 1.93; P =.50) and the CCIST (three studies, MD = −0.77; 95% CI: −3.03, 1.49; P =.50). A pooled overall meta-analysis revealed similar results (eight studies, effect size = −0.30; 95% CI: −0.79, 0.18; P =.22). However, heterogeneity for all meta-analyses was high (I² > 95%, P <.01), suggesting significant variation in the included studies. Conclusions: Based on published objective olfaction outcomes after sellar and parasellar ESBS, there was no significant difference between preoperative and postoperative olfaction. Further prospective studies using validated objective measures of olfaction are required to improve our understanding on this subject. Level of Evidence: 2a. Laryngoscope, 129:1998–2007, 2019.

Original language	English (US)
Pages (from-to)	1998-2007
Number of pages	10
Journal	Laryngoscope
Volume	129
Issue number	9
DOIs	https://doi.org/10.1002/lary.28003
State	Published - Sep 2019

Keywords

Olfaction
anterior skull base
chordoma
endoscopic skull base
expanded endonasal approach
meta-analysis
pituitary
smell
systematic review
trans sphenoid
transclival
transcribriform
transnasal

ASJC Scopus subject areas

Otorhinolaryngology

Access to Document

10.1002/lary.28003

Cite this

@article{34ef4cef437441e1904a7de61be7e976,

title = "Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta-analysis",

abstract = "Objectives: Determine the effect of endoscopic skull base surgery (ESBS) on long-term olfactory outcomes after surgery. Methods: An English-language search was conducted using the Cochrane, MEDLINE, Scopus, and Embase databases from January 2000 to October 2017 for adult patients undergoing ESBS with subjective and objective olfaction outcomes. Two authors independently examined articles to identify those meeting inclusion criteria. Studies examining objective olfactory outcomes after ESBS were included in the meta-analysis. A random-effects meta-analysis of patients undergoing sellar and parasellar ESBS was conducted to compare preoperative and postoperative olfactory outcomes using the University of Pennsylvania Smell Identification Test (UPSIT) and Cross-Cultural Smell Identification Test (CCSIT). Results: Among 339 eligible articles, 29 articles met inclusion criteria. Twenty-five of these focused on sellar and parasellar tumors. Individual articles not meeting criteria for meta-analysis were qualitatively reported. Meta-analysis showed there was no difference in preoperative and postoperative olfactory function after sellar and parasellar ESBS based on the UPSIT (five studies, mean difference [MD] = −1.03; 95% CI: −3.98, 1.93; P =.50) and the CCIST (three studies, MD = −0.77; 95% CI: −3.03, 1.49; P =.50). A pooled overall meta-analysis revealed similar results (eight studies, effect size = −0.30; 95% CI: −0.79, 0.18; P =.22). However, heterogeneity for all meta-analyses was high (I2 > 95%, P <.01), suggesting significant variation in the included studies. Conclusions: Based on published objective olfaction outcomes after sellar and parasellar ESBS, there was no significant difference between preoperative and postoperative olfaction. Further prospective studies using validated objective measures of olfaction are required to improve our understanding on this subject. Level of Evidence: 2a. Laryngoscope, 129:1998–2007, 2019.",

keywords = "Olfaction, anterior skull base, chordoma, endoscopic skull base, expanded endonasal approach, meta-analysis, pituitary, smell, systematic review, trans sphenoid, transclival, transcribriform, transnasal",

author = "Yin, {Linda X.} and Low, {Christopher M.} and Puccinelli, {Cassandra L.} and O'Brien, {Erin K.} and Stokken, {Janalee K.} and {Van Abel}, {Kathryn M.} and Janus, {Jeffrey R.} and Link, {Michael J.} and {Van Gompel}, {Jamie J.} and Garret Choby",

note = "Publisher Copyright: {\textcopyright} 2019 The American Laryngological, Rhinological and Otological Society, Inc.",

year = "2019",

month = sep,

doi = "10.1002/lary.28003",

language = "English (US)",

volume = "129",

pages = "1998--2007",

journal = "Laryngoscope",

issn = "0023-852X",

publisher = "John Wiley and Sons Inc.",

number = "9",

}

TY - JOUR

T1 - Olfactory outcomes after endoscopic skull base surgery

T2 - A systematic review and meta-analysis

AU - Yin, Linda X.

AU - Low, Christopher M.

AU - Puccinelli, Cassandra L.

AU - O'Brien, Erin K.

AU - Stokken, Janalee K.

AU - Van Abel, Kathryn M.

AU - Janus, Jeffrey R.

AU - Link, Michael J.

AU - Van Gompel, Jamie J.

AU - Choby, Garret

PY - 2019/9

Y1 - 2019/9

N2 - Objectives: Determine the effect of endoscopic skull base surgery (ESBS) on long-term olfactory outcomes after surgery. Methods: An English-language search was conducted using the Cochrane, MEDLINE, Scopus, and Embase databases from January 2000 to October 2017 for adult patients undergoing ESBS with subjective and objective olfaction outcomes. Two authors independently examined articles to identify those meeting inclusion criteria. Studies examining objective olfactory outcomes after ESBS were included in the meta-analysis. A random-effects meta-analysis of patients undergoing sellar and parasellar ESBS was conducted to compare preoperative and postoperative olfactory outcomes using the University of Pennsylvania Smell Identification Test (UPSIT) and Cross-Cultural Smell Identification Test (CCSIT). Results: Among 339 eligible articles, 29 articles met inclusion criteria. Twenty-five of these focused on sellar and parasellar tumors. Individual articles not meeting criteria for meta-analysis were qualitatively reported. Meta-analysis showed there was no difference in preoperative and postoperative olfactory function after sellar and parasellar ESBS based on the UPSIT (five studies, mean difference [MD] = −1.03; 95% CI: −3.98, 1.93; P =.50) and the CCIST (three studies, MD = −0.77; 95% CI: −3.03, 1.49; P =.50). A pooled overall meta-analysis revealed similar results (eight studies, effect size = −0.30; 95% CI: −0.79, 0.18; P =.22). However, heterogeneity for all meta-analyses was high (I2 > 95%, P <.01), suggesting significant variation in the included studies. Conclusions: Based on published objective olfaction outcomes after sellar and parasellar ESBS, there was no significant difference between preoperative and postoperative olfaction. Further prospective studies using validated objective measures of olfaction are required to improve our understanding on this subject. Level of Evidence: 2a. Laryngoscope, 129:1998–2007, 2019.

AB - Objectives: Determine the effect of endoscopic skull base surgery (ESBS) on long-term olfactory outcomes after surgery. Methods: An English-language search was conducted using the Cochrane, MEDLINE, Scopus, and Embase databases from January 2000 to October 2017 for adult patients undergoing ESBS with subjective and objective olfaction outcomes. Two authors independently examined articles to identify those meeting inclusion criteria. Studies examining objective olfactory outcomes after ESBS were included in the meta-analysis. A random-effects meta-analysis of patients undergoing sellar and parasellar ESBS was conducted to compare preoperative and postoperative olfactory outcomes using the University of Pennsylvania Smell Identification Test (UPSIT) and Cross-Cultural Smell Identification Test (CCSIT). Results: Among 339 eligible articles, 29 articles met inclusion criteria. Twenty-five of these focused on sellar and parasellar tumors. Individual articles not meeting criteria for meta-analysis were qualitatively reported. Meta-analysis showed there was no difference in preoperative and postoperative olfactory function after sellar and parasellar ESBS based on the UPSIT (five studies, mean difference [MD] = −1.03; 95% CI: −3.98, 1.93; P =.50) and the CCIST (three studies, MD = −0.77; 95% CI: −3.03, 1.49; P =.50). A pooled overall meta-analysis revealed similar results (eight studies, effect size = −0.30; 95% CI: −0.79, 0.18; P =.22). However, heterogeneity for all meta-analyses was high (I2 > 95%, P <.01), suggesting significant variation in the included studies. Conclusions: Based on published objective olfaction outcomes after sellar and parasellar ESBS, there was no significant difference between preoperative and postoperative olfaction. Further prospective studies using validated objective measures of olfaction are required to improve our understanding on this subject. Level of Evidence: 2a. Laryngoscope, 129:1998–2007, 2019.

KW - Olfaction

KW - anterior skull base

KW - chordoma

KW - endoscopic skull base

KW - expanded endonasal approach

KW - meta-analysis

KW - pituitary

KW - smell

KW - systematic review

KW - trans sphenoid

KW - transclival

KW - transcribriform

KW - transnasal

UR - http://www.scopus.com/inward/record.url?scp=85065209873&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85065209873&partnerID=8YFLogxK

U2 - 10.1002/lary.28003

DO - 10.1002/lary.28003

M3 - Review article

C2 - 31032986

AN - SCOPUS:85065209873

SN - 0023-852X

VL - 129

SP - 1998

EP - 2007

JO - Laryngoscope

JF - Laryngoscope

IS - 9

ER -

Olfactory outcomes after endoscopic skull base surgery: A systematic review and meta-analysis

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this