title: Olfactory preservation during anterior interhemispheric approach for anterior skull base lesions: technical note.
abstract: Anosmia is not a rare complication of surgeries that employ the anterior interhemispheric approach. Here, we present a fibrin-gelatin fixation method that provides reinforcement and moisture to help preserve the olfactory nerve when using the anterior interhemispheric approach and describe the results and outcomes of this technique. We analyze the outcomes with this technique in 45 patients who undergo surgery for aneurysms, brain tumors, or other pathologies via the anterior interhemispheric approach. Anosmia occurred in 4 patients (8.8%); it was transient in 2 (4.4%) and permanent in the remaining 2 (4.4%). Brain tumors clearly attached to the olfactory nerve were resected in the patients with permanent anosmia. We found a significant difference in the presence of anosmia between patients with or without lesions that were attaching the olfactory nerve (p = 0.011). Our results suggested that fibrin-gelatin fixation method can reduce the reported risk of anosmia. However, the possibility of olfactory nerve damage is relatively high when operating on brain tumors attaching olfactory nerve.
authors.affiliation: Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan. s00-078@nms.ac.jp.
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Matano
authors.affiliation: Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Murai
authors.affiliation: Department of Neurological Surgery, Chiba Hokusou Hospital, Chiba, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Mizunari
authors.affiliation: Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Tateyama
authors.affiliation: Department of Neurological Surgery, Chiba Hokusou Hospital, Chiba, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Kobayashi
authors.affiliation: Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Adachi
authors.affiliation: Department of Neurological Surgery, Teishinkai Hospital, Sapporo, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Kamiyama
authors.affiliation: Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Morita
authors.affiliation: Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Teramoto
mesh_terms: D000328:Adult; D000368:Aged; D003397:Craniopharyngioma / Q000473:pathology / Q000601:surgery; D003399:Craniotomy; D005260:Female; D005337:Fibrin; D005780:Gelatin; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology / Q000601:surgery; D008297:Male; D008579:Meningioma / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000379:methods*; D000857:Olfaction Disorders / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology*; D061219:Olfactory Nerve Injuries / Q000209:etiology / Q000523:psychology; D011183:Postoperative Complications / Q000453:epidemiology / Q000523:psychology*; D019291:Skull Base / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000601:surgery*; D012903:Smell; D055815:Young Adult
chemical_list: D005780:Gelatin; D005337:Fibrin
keywords: Aneurysm; Anosmia; Anterior interhemispheric approach; Meningiomas; Skull base