title: Anatomic Changes Caused by Endoscopic Endonasal Transsphenoidal Surgery and Their Effects on Nasal Functions.
abstract: We evaluated postoperative changes in nasal cavity dimensions and their effects on nasal functions and symptoms.
  
  
  
  Case series with chart review.
  
  
  
  Tertiary referral center.
  
  
  
  We studied patients who underwent binostril, 4-hand endoscopic endonasal transsphenoidal approach surgery with the bilateral modified nasoseptal rescue flap technique. Pre- and postoperative paranasal computed tomography scans were used to assess nasal cavity dimensional changes at 4 levels. We also performed several pre- and postoperative tests, including the Connecticut Chemosensory Clinical Research Center test and the Cross-Cultural Smell Identification Test (n = 119) to evaluate olfactory functions. Also, the Nasal Obstruction Symptoms Evaluation, the Sino-Nasal Outcome Test-20, and a visual analog scale were used (n = 157) to record subjective symptoms. We compared these data with the pre- and postoperative nasal cavity dimensions.
  
  
  
  Two-dimensional objective increases in nasal passage dimensions were evident postoperatively (all cross-sectional areas, P < .001, except choana and left inferior turbinate). However, these did not correlate with subjectively assessed symptoms (Nasal Obstruction Symptoms Evaluation, all cross-sectional areas, P ≥ .05, except right middle turbinate; Sino-Nasal Outcome Test-20, all cross-sectional areas, P ≥ .05) or olfactory dysfunction evaluated with the Connecticut Chemosensory Clinical Research Center test (all cross-sectional areas, P ≥ .05) or the Cross-Cultural Smell Identification Test (all cross-sectional areas, P ≥ .05).
  
  
  
  Endoscopic endonasal transsphenoidal approach surgery altered the patients' nasal anatomy, but the changes in nasal cavity dimensions did not affect nasal functions and symptoms. These results will help surgeons to appropriately expose the surgical field during endoscopic endonasal transsphenoidal approach surgery.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Do Hyun
authors.initials: do H
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yong-Kil
authors.initials: YK
authors.lastname: Hong
authors.affiliation: Department of Neurosurgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sin-Soo
authors.initials: SS
authors.lastname: Jeun
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yong Jin
authors.initials: YJ
authors.lastname: Park
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Soo Whan
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Cho
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Boo Young
authors.initials: BY
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sungwoo
authors.initials: S
authors.lastname: Han
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Young Hoon
authors.initials: YH
authors.lastname: Jung
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yong Joo
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea kswent@catholic.ac.kr.
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: computed tomography; endoscope; nasal symptom; transsphenoidal approach