title: The effect of two sphenoidotomy approaches on the sense of smell: trans-ethmoidal versus trans-sphenoethmoidal.
abstract: There are generally two methods to access the sphenoid sinus: either through the natural ostium {trans-sphenoethmoidalor via sphenoethmoidal recess), or by creating a second opening through the posterior ethmoids (trans-ethmoidal).This study psychophysically and subjectively evaluates the effect of the trans-sphenoethmoidal technique to the trans-ethmoidal technique for sphenoid sinusotomy on olfactory function.
  
  
  
  Prospective cohort analysis of 48 patients with comparable sinus disease underwent primary sphenoidotomy via transsphenoethmoidal(n = 24) versus trans-ethmiodal (n = 24) technique between September 2011 and February 2012. The patients had their olfaction measured psychophysically with "Sniffin' Sticks" and subjectively with a visual analogue scale (VAS) pre-operatively and at 5 weeks post-operatively.
  
  
  
  Psychophysical scores from the Sniffin' sticks provide a Threshold, Discrimination and Identification (TDI) score out of 48.The TDI change (post-operative TDI score minus pre-operative score) as well as VAS change (post-operative VAS minus pre-operativeVAS) were analyzed using t-test analysis, which showed no significant difference between the two measurements.
  
  
  
  If the trans-sphenoethmoidal technique is done meticulously, patients have the same olfactory relief, psychophysically and subjectively, as those undergoing the trans-ethmoidal technique.
authors.forename: A
authors.initials: A
authors.lastname: Thamboo
authors.forename: B A
authors.initials: BA
authors.lastname: Chang
authors.forename: A R
authors.initials: AR
authors.lastname: Habib
authors.forename: J
authors.initials: J
authors.lastname: Manji
authors.forename: I
authors.initials: I
authors.lastname: Hathorn
authors.forename: V
authors.initials: V
authors.lastname: Sunkaraneni
authors.forename: A
authors.initials: A
authors.lastname: Javer
mesh_terms: D002908:Chronic Disease; D005004:Ethmoid Bone / Q000601:surgery*; D015521:Ethmoid Sinusitis / Q000601:surgery; D005260:Female; D015522:Frontal Sinusitis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D055696:Olfactory Perception; D011446:Prospective Studies; D012220:Rhinitis / Q000601:surgery; D012678:Sensation Disorders / Q000517:prevention & control*; D012903:Smell; D013101:Sphenoid Sinus / Q000601:surgery*